Toxic neuropathies and myopathies

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Abstract
This review first considers toxic neuropathies of recent interest, including those caused by antineoplastic and antiretroviral drugs, agents that affect methylation reactions, vitamin and herbal preparations, and certain occupational exposures. The discussion points out the interesting phenomenon of “coasting,” the strategy of using neurotrophic factors to combat toxic neuropathies, and the inapparent risks in “health foods.” Second, it considers toxic myopathy syndromes, including zidovudine myopathy and its differentiation from HIV-associated inflammatory myopathy, cholesterol-lowering agent myopathies, acute myopathy with selective loss of myosin filaments due to neuromuscular blocking agents and corticosteroids, the eosinophilia myalgia syndrome, and colchicine myoneuropathy. Some of these syndromes illustrate important toxicologic principles about recognition of rare disorders, unanticipated temporal relationships with exposure, and risk factor assessment.

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