[A case of neuropathy mimicking Guillain-Barré syndrome after arsenic intoxication].
BACKGROUND
Chronic arsenic toxicity is a global health problem affecting millions of people. Acute arsenic poisoning is less frequent and it is most often lethal. Therefore, its consequences are not well known, more precisely its neurological consequences.


METHODS
We report a case of Guillain-Barré-like syndrome and encephalopathy after acute arsenical poisoning in a 50 year-old man. After 4 month follow-up, the improvement was slow and limited with persistent motor and proprioceptive deficits.


CONCLUSIONS
The most frequent neurological complication induced by acute arsenical poisoning is a distal, symmetrical, sensory, axonal polyneuropathy. Yet the clinical course and the electrophysiological findings may also suggest a Guillain-Barré like syndrome. Moreover, the chelating is not very effective on the neurological complications.


CONCLUSIONS
Any discrepancies in the clinical course of a Guillain-Barré syndrome shall lead to reconsider the diagnosis. The association of gastro-intestinal disorders, skin lesions, and encephalopathy and mood disorders leads to discuss intoxication with heavy metal and more precisely with arsenic. Moreover, the chelating is not very effective on the neurological complications.
Perriol
M-P
MP
Neurologie et Pathologie du Mouvement, Clinique Neurologique, EA 2683, CHRU, Lille.
Devos
D
D
Hurtevent
J-F
JF
Tiffreau
V
V
Saulnier
F
F
Destee
A
A
Defebvre
L
L
D058186:Acute Kidney Injury / Q000139:chemically induced; D020261:Arsenic Poisoning / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D002614:Chelating Agents / Q000627:therapeutic use; D015913:Chelation Therapy; D003937:Diagnosis, Differential; D004112:Dimercaprol / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D020275:Guillain-Barre Syndrome / Q000175:diagnosis*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced; D009431:Neural Conduction; D010259:Paranoid Disorders / Q000139:chemically induced; D012871:Skin Diseases / Q000139:chemically induced; D013406:Suicide, Attempted
D002614:Chelating Agents; D004112:Dimercaprol