REVERSIBLE NEUROLOGIC COMPLICATIONS IN CH RONIC-ALCOHOLISM WITH HYPOPHOSPHATEMIA

Severe hypophosphatemia is rare, usually affecting chronic alcoholics and patients under total parenteral nutrition. The most important clin ical features are rhabdomyolysis and neurological deficits. The latter may take various forms and can affect the peripheral as well as the c entral nervous system. Symptoms of polyradiculitis with progressive pa resis or cerebellar symptoms such as dysarthria, dysphagia and ataxia are frequent manifestations. Rarely hypophosphatemia can cause confusi onal states, epileptic seizure or coma. The differential diagnosis inc ludes Guillain-Barre polyradiculitis, diffuse encephalopathy, Wernicke encephalopathy and central pontine myelinolysis. We describe the neur ological signs in a female chronic alcoholic who developed severe atax ia and tetraparesis after a week's course of parenteral, phosphate-fre e nutrition. Complete recovery occurred after adequate substitution of phosphate.