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Disulfiram neuropathy

A neurofilamentous distal axonopathy

Department of Pathology (Dr. Ansbacher), University of Missouri, Columbia, MO, and the Departments of Pathology (Neuropathology) and Neurology (Drs. Bosch and Cancilla), University of Iowa Hospital and Clinics, Iowa City, IA.

Disulfiram is used to treat alcoholism and is known to cause peripheral neuropathy; few reports of biopsied human nerves have revealed axonal degeneration and loss of myelinated fibers. We studied a 22-year-old woman with severe sensorimotor neuropathy following treatment with disulfiram for 6 months. Histologic studies of the sural nerve revealed a neurofilamentous axonopathy with rare enlarged axons distended by neurofilaments. Disulfiram is converted enzymatically to carbon disulfide, which causes neurofilamentous distal axonopathy in animals. Similar changes in human nerve after disulfiram administration suggest that carbon disulfide is the toxic agent.

Address correspondence and reprint requests to Dr. Ansbacher, Department of Pathology, University of Missouri Hospital and Clinics, Columbia, MO 65212.

This investigation was supported by Grant R25 CA 180105 from the National Cancer Institute, Department of Health, Education and Welfare.

Presented in part at the thirty-third annual meeting of the American Academy of Neurology, Toronto, Ontario, April 1981.

Accepted for publication September 2, 1981.

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