Distal lower extremity paresthesia and foot drop developing during adalimumab therapy

The development of tumor necrosis factor inhibitor biologic therapy is arguably one of the most Significant achievements in the treatment of rheumatic diseases to date. Neurologic events suggestive of demyelination have been reported for patients receiving treatment with the antitumor necrosis factor agents etanercept and infliximab. We describe the onset of lower extremity paresthesia and foot drop in a patients who was receiving adalimumab for treatment of psoriasis and examine the relationship of tumour necrosis factor antagonism and demyelinating disease.