Can mustard gas induce late-onset polyneuropathy?

Mustard gas, lethal in high doses, affects multiple organs such asskin, eye and respiratory system. We studied the development of late onset mustardinduced polyneuropathy among chemically wounded Iranian veterans. In this descriptive study, 100 chemically wounded Iranian veteranswith severe eye involvement were examined for any signs and symptoms ofpolyneuropathy by an internist. 20 patients were suspected to have neurologicalsymptoms or signs. These patients were examined by a neurologist again. 13showed abnormal neurological symptoms. Electrodiagnostic exams were performedfor this group by another physician. 13 veterans had abnormal neurological exam results with prominentsensory signs and symptoms in almost all of them. Brisk deep tendon reflexes werefound in 3 cases. Electrodiagnostic studies were compatible with axonal type distalsensory polyneuropathy in 6 subjects. To the best of our knowledge, this is the first report of late onsetpolyneuropathy among chemically-wounded victims who were exposed to mustardgas. The pathophysiology of this form of neuropathy is still unknown. Unlike mosttoxic neuropathies, obvious clinical signs and symptoms appeared several years afterexposure. No specific treatment for polyneuropathy due to chemical weaponsexposure has been described to date.