Hypophosphatemia with reversible ataxia and quadriparesis

A malnourished alcoholic man with severe hypophosphatemia developed ataxia, severe proprioceptive deficit, and quadriparesis that worsened during refeeding. Evoked response and EMG studies demonstrated the central location of the rapidly reversible conduction block. This syndrome can mimic a number of entities including the Landry-Guillain-Barre (LGB) syndrome, acute brainstem disease, and certain deficiency states. The neurologic features of hypophosphatemia are reviewed.