Neuropathies, Toxic

Axonal polyneuropathy may follow exposure to

• Industrial agents or pesticides, such as acrylamide, organophosphorus compounds, hexacarbon solvents, methyl bromide, and carbon disulfide

• Metals, such as arsenic, thallium, mercury, and lead

• High doses of such certain medications, such as phenytoin, amiodarone, perhexiline, isoniazid, nitrofurantoin, vincristine, and pyridoxine

Bulbar and distal sensorimotor polyneuropathy may follow diphtheria

Diphtheritic neuropathy

• Results from a neurotoxin released by the causative organism and is common in many areas

• Palatal weakness may develop 2–4 weeks after infection of the throat

• Infection of the skin may similarly be followed by focal weakness of neighboring muscles

• Disturbances of visual accommodation may occur about 4–5 weeks after infection

• Distal sensorimotor demyelinating polyneuropathy may occur after 1–3 months

Detailed occupational, environmental, and medical histories and recognition of clusters of cases are important in suggesting the diagnosis

Prevent further exposure to the causal agent

Isoniazid neuropathy is prevented by pyridoxine supplementation