Subacute arsenic neuropathy: clinical and electrophysiological observations

Two patients with subacute arsenic neuropathy are described and the results of serial conduction velocity determinations from the very early stages of the illness to partial recovery are reported. Sensory and motor deficits were maximal within four weeks of the estimated time of exposure. Recovery was slow, with only partial improvement of the neurological deficits two years after onset of the illness. Progressive slowing of motor conduction velocity was observed in the first three months followed by a gradual increase in velocity thereafter. The possible mechanisms underlying the temporal profile of the electrophysiological changes are considered. The need for initiating chelation therapy before the development of the neuropathy is emphasised.