Acute axonal peripheral polyneuropathy following acute arsenic exposure in an industrial worker: A case report

Abstract

Arsenic exposure can produce diverse neurological manifestations, with acute presentations being uncommon and often misdiagnosed. Acute arsenic-induced peripheral neuropathy may mimic immune-mediated conditions such as Guillain–Barré syndrome. We report a 44-year-old industrial worker who developed acute symmetrical distal paraesthesia and sensory ataxia following ingestion of contaminated water. Examination revealed a stocking–glove sensory pattern with preserved motor strength. Laboratory evaluation demonstrated markedly elevated blood and urinary arsenic levels, confirming toxic exposure. Initial nerve conduction studies were normal, while repeat testing showed sensory–motor axonal polyneuropathy. The patient was treated with oral succimer for 14 days, resulting in clinical improvement and reduction in urinary arsenic levels. This case highlights the importance of environmental exposure history and early chelation therapy in atypical acute neuropathies.