Peripheral neuropathy after concomitant dimethyl sulfoxide use and sulindac therapy

The case is presented of a 63-year-old man with a long history of degenerative arthritis who took sulindac (Clinoril) 200 mg BID for 6 months with no untoward effects. Then, without physician knowledge, he began using 90% dimethyl sulfoxide (DMSO) topically to his upper and lower extremities. Shortly thereafter, he developed a profound mixed sensorimotor peripheral neuropathy. Serial electromyographic and nerve conducion studies performed at intervals of several months for 1 year suggested both segmental demyelination and axonal neuropathy. The patient experienced initial deterioration followed by gradual but incomplete recovery.