Case reportSensory-motor axonal polyneuropathy involving cranial nerves: An uncommon manifestation of disulfiram toxicity

•An axonal neuropathy due to disulfiram is extremely rare.•Disulfiram neurotoxicity is considered a dose-dependent effect.•We describe a sub-acute severe polyneuropathy with bulbar involvement, after 500 mg.•Such presentation has never been described before with 500 mg/d.

Disulfiram (tetraethylthiuram disulfide) has been used for the treatment of alcohol dependence. An axonal sensory-motor polyneuropathy with involvement of cranial pairs due to disulfiram is exceedingly rare. The authors report a unique case of an extremely severe axonal polyneuropathy involving cranial nerves that developed within weeks after a regular dosage of 500 mg/day disulfiram. To the authors best knowledge, such a severe and rapidly-progressive course has never been described with disulfiram dosages of only 500 mg/day.