- Dedication
- Preface
- Acknowledgments
- 1 A 35-Year-Old Man with Progressive Left-Hand Weakness
- 2 A 54-Year-Old Male with Right-Hand Weakness
- 3 A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
- 4 A 45-Year-Old Male with Toxin Exposure
- 5 A 48-Year-Old with Progressive Weakness and Pain
- 6 A 30-Year-Old Male Requiring Management of Progressive Weakness
- 7 A 61-Year-Old Male with Severe Shoulder and Cervical Pain
- 8 A 55-Year-Old Male with Right Foot Weakness
- 9 A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- 10 A 55-Year-Old Female with Slowly Progressive Weakness
- 11 A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery
- 12 A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness
- 13 A 40-Year-Old Female with Increasing Arm Pain and Numbness
- 14 A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss
- 15 A 68-Year-Old Male with Progressive Numbness and Gait Difficulties
- 16 A 28-Year-Old Male with Weakness in the Setting of Cancer
- 17 A 44-Year-Old Man with Bilateral Facial Droop
- 18 A 41-Year-Old Male with Foot Drop and Malaise
- 19 A 44-Year-Old Female with Buttock Pain
- 20 A 50-Year-Old Woman with Burning Feet
- 21 A 56-Year-Old Woman with Small-Fiber Neuropathy and Progressive Leg Pain and Weakness
- 22 A 34-Year-Old Male with Possible Myopathic Process
- 23 A 39-Year-Old Man with Low Back Pain and Scapular Winging
- 24 A 52-Year-Old Female with Weakness and Droopy Eyelids
- 25 A 20-year-Old Male with Acute Lower-Extremity Weakness
- 26 A 19-Year-Old Male with Stiffness and Weakness After Waking
- 27 A 68-Year-Old Female with Progressive Pain and Weakness
- 28 An 18-Year-Old Male with Slowly Progressive Weakness
- 29 A 30-Year-Old Male with Severe Cramps
- 30 A 72-Year-Old Female with Facial Weakness and Droopy Eyelids
- 31 An 80-Year-Old Myasthenia Gravis Patient with Worsening Weakness
- 32 A 44-Year-Old Male with Subacute Onset of Syncope
- 33 A 46-Year-Old Man with Double Vision and Proximal Leg Weakness
- 34 A 2-Month-Old Boy with Acute Diffuse Weakness
- Index
(p. 21) A 45-Year-Old Male with Toxin Exposure
- Chapter:
- (p. 21) A 45-Year-Old Male with Toxin Exposure
- Author(s):
Jeffrey A. Cohen
, Justin J. Mowchun
, Victoria H. Lawson
, and Nathaniel M. Robbins
- DOI:
- 10.1093/med/9780190491901.003.0004
A patient presents with a sensorimotor neuropathy and believes he has been poisoned. The approach to the differential diagnosis of arsenic toxicity is presented. Comparisons with mimics of this entity are made, and clinical clues to its early detection are provided. There are typical skin and nail changes with can occur with arsenic poisoning. Arsenic poisoning can appear similar to Guillain-Barre syndrome with gastrointestinal symptoms and later an ascending paralysis. Urine arsenic levels are more reliable than blood levels. Hair and nail samples are very useful in confirming the diagnosis. Electrodiagnostic testing confirmed an axonal polyneuropathy. Treatment of arsenic poisoning is discussed. The recent lead contamination in Flint Michigan points out that heavy metal poisoning still occurs despite public health awareness.
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- Dedication
- Preface
- Acknowledgments
- 1 A 35-Year-Old Man with Progressive Left-Hand Weakness
- 2 A 54-Year-Old Male with Right-Hand Weakness
- 3 A 50-Year-Old Male with Speech, Swallowing, and Behavioral Difficulties
- 4 A 45-Year-Old Male with Toxin Exposure
- 5 A 48-Year-Old with Progressive Weakness and Pain
- 6 A 30-Year-Old Male Requiring Management of Progressive Weakness
- 7 A 61-Year-Old Male with Severe Shoulder and Cervical Pain
- 8 A 55-Year-Old Male with Right Foot Weakness
- 9 A 63-Year-Old Male with Severe Flaccid Weakness Post Motor Vehicle Accident
- 10 A 55-Year-Old Female with Slowly Progressive Weakness
- 11 A 40-Year-Old Female with Balance Problems and Numbness After Bariatric Surgery
- 12 A 55-Year-Old Female with a History of Right Foot Drop and Left Hand Weakness
- 13 A 40-Year-Old Female with Increasing Arm Pain and Numbness
- 14 A 59-Year-Old Man with Progressive Difficulties with Balance and Weight Loss
- 15 A 68-Year-Old Male with Progressive Numbness and Gait Difficulties
- 16 A 28-Year-Old Male with Weakness in the Setting of Cancer
- 17 A 44-Year-Old Man with Bilateral Facial Droop
- 18 A 41-Year-Old Male with Foot Drop and Malaise
- 19 A 44-Year-Old Female with Buttock Pain
- 20 A 50-Year-Old Woman with Burning Feet
- 21 A 56-Year-Old Woman with Small-Fiber Neuropathy and Progressive Leg Pain and Weakness
- 22 A 34-Year-Old Male with Possible Myopathic Process
- 23 A 39-Year-Old Man with Low Back Pain and Scapular Winging
- 24 A 52-Year-Old Female with Weakness and Droopy Eyelids
- 25 A 20-year-Old Male with Acute Lower-Extremity Weakness
- 26 A 19-Year-Old Male with Stiffness and Weakness After Waking
- 27 A 68-Year-Old Female with Progressive Pain and Weakness
- 28 An 18-Year-Old Male with Slowly Progressive Weakness
- 29 A 30-Year-Old Male with Severe Cramps
- 30 A 72-Year-Old Female with Facial Weakness and Droopy Eyelids
- 31 An 80-Year-Old Myasthenia Gravis Patient with Worsening Weakness
- 32 A 44-Year-Old Male with Subacute Onset of Syncope
- 33 A 46-Year-Old Man with Double Vision and Proximal Leg Weakness
- 34 A 2-Month-Old Boy with Acute Diffuse Weakness
- Index
