[Disulfiram-induced peripheral neuropathies (author's transl)]

Area of Science:

• Neuroscience
• Pharmacology
• Toxicology

Background:

• Disulfiram is a medication used to deter alcohol consumption by causing unpleasant side effects when alcohol is ingested.
• While generally effective, disulfiram can have various adverse effects, including neurological complications.
• Peripheral neuropathies are a known, though not common, side effect of disulfiram treatment.

Observation:

• A 28-year-old woman developed a confusional attack with hallucinations and lower limb motor deficiency while on disulfiram.
• An increased dosage of disulfiram led to quadriplegia and paralysis of cranial nerves (facial and glosso-pharyngeal).
• Recovery from paralysis was rapid in cranial and upper limb areas but notably slow in the lower limbs.

Findings:

• The patient's symptoms represent an exceptional presentation of disulfiram-induced peripheral neuropathy.
• This case demonstrates a severe form of multiple paralysis accompanied by significant psychic disturbances.
• The dose-dependent nature of the neurological toxicity is suggested by the progression of symptoms with increased disulfiram dosage.

Implications:

• Clinicians should be vigilant for potential neurological and psychiatric side effects of disulfiram, even at standard doses.
• This case underscores the importance of careful dosage titration and regular monitoring for neurological changes in patients treated with disulfiram.
• Further research may be warranted to elucidate the precise mechanisms underlying severe disulfiram-induced neurotoxicity and identify at-risk individuals.