Acute Axonal Polyneuropathy in a Chronic Alcoholic Patient:A Rare Presentation

Abstract

Guillain Barre Syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy of autoimmune nature, characterized by rapidly progressive, symmetric weakness and areflexia. Acute motor sensory axonal neuropathy is a variant of GBS with motor paralysis, hyporeflexia/areflexia, and sensory loss. Alcohol produces central nervous system toxicity as its principal side effects. Alcoholic neuropathy is a mixed sensory and motor disorder affecting large and small fibers to varying degrees. In contrast to the classic, slowly progressive polyneuropathy in alcoholic patients, acute forms, clinically mimicking GBS, are rare. This is a case of a 37 year old chronic alcoholic lady presenting with subacute onset weakness of both lower limbs whose laboratory data indicate neuropathy of acute motor sensory axonal pattern. We emphasize that acute alcoholic neuropathy has to be distinguished from GBS and other forms of acute polyneuropathy by using clinical, laboratory, and electrophysiological data for therapeutic and prognostic concerns.