Porphyric Neuropathy is the conditino in which acute intermittent porphyria may have neuropathy which is acute and resembles infective polyneuritis. The neuropathy generally occurs in younger age group patients.
There is history of recurrent attacks of pain abdomen along with psychotic behavior.
Precipitation of illness occurs following surgery, infection or after intake of drugs like Barbiturates, Phenytoin and sulfonamides etc.
Neuropathy of porphyria is symmetrical, predominantly motor and involves mainly lower extremities. It is often ascending in nature and may cause respiratory embarrassment.
Cranial nerve palsies may occur (7th & 10th). There is presence of hypaesthesia with loss of tendon jerks.
Autonomic nervous system involvement in the form of tachycardia and hypertension may be seen.
Diagnosis of porphyria shall rest on change in color of urine to port wine on standing. There is presence of porphobilinogen.
Post antirabies vaccine neuropathy. It is a rare sequelae of antirabic treatment where old vaccine (Semple carbolised vaccine) is used.
The incidence varies from 1 in 1000 to 4000 patients and generally develops with 7-40 days of first injection.
Patient may show an ascending paralysis or transverse myelitis or polyneuropathy involving various peripheral nerves. Major pathology is axonal degeneration with perivascular congestion.
Death may occur depending on the severity of the condition. Treatment is by heavy doses of corticosteroids and cytotoxic drugs (cyclophosphamide). Prognosis is variable.