The prevalence of various forms of peripheral neuropathy has not been previously assessed in

association with diffuse mucosal and cutaneous maculopapular and vesicular erythema, for 10 days previously. The physical examination showed marked postural hypotension (supine blood pressure 120/80 mm Hg, unobtainable in a standing position) and fixed tachycardia (>1 00/min, unchanged with changes of position). There was a total absence of sweating, and hair and fingernails were dystrophic. Pupils were normal in size but unequal; the larger right pupil was unreactive to light, and accommodation, whereas the left pupil reacted slightly to light. Extraocular movements, pursuit and convergence were intact; corneal reflexes were present. Lacrimation was completely absent. The salivary flow was reduced and taste was distorted.The other cranial nerves were unremarkable. Strength was mildly impaired in the distal limb muscles; moderate limb dysmetria was observed. Light touch sense was impaired over the neck, the upper trunk and the proximal part of the arms, especially on the right side. Pain sensation was markedly impaired or absent over the upper arms and the trunk, apart from a patchy area including dermatomes from D6 to D10. Thermal discrimin-

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