LAUSR

to the low oral bioavailability of realgar. Other arsenates such as orpiment (As2S3) and arsenic trioxide (As2O3) are used externally only because of higher toxicity. Arsenic-induced neuropathy can occur in both acute and chronic intoxication. It can affect both large and small fibers. Sensorimotor axonal pattern is usual but demyelination is also possible. The neuropathy commonly develops within 3 weeks of exposure. Typical symptoms include painful dysesthesia over extremities signifying small-fiber neuropathy, and loss of proprioception and sensory ataxia suggestive of large-fiber disease. Neurological deficits can be life long. Benefit of chelating therapy in late stage of neuropathy is limited.3