Here's the
official explanation provided by the GMAC for this question:
This sentence refers to two unfortunate types of occurrences; automobile accidents and injuries. It uses the construction
not only …
but also. Because
not only is placed after the subject and modifies
causes automobile accidents, a coherent completion of the structure needs another verb or verb phrase that has the same subject. The original version illogically completes the structure with a separate clause.
Option A: Because the portion of the sentence following
but also is a grammatically complete structure with its own subject and predicate, it functions as an independent clause, but the absence of a comma after
accidents makes it unclear whether this is how it is intended. Since
not only immediately precedes a verb,
but also must also immediately precede a verb or verb phrase rather than a noun phrase.
Option B: With this structure, the sentence offers two separate facts; that alcohol causes accidents and that there may be more severe injuries. Since the two topics are put together in a single sentence, it is rhetorically odd that the sentence does not say what the connection is. Because the portion of the sentence following
but also is a grammatically complete structure with its own subject and predicate, it functions as an independent clause, but the absence of a comma after
accidents makes it unclear whether this is how it is intended. Since
not only immediately precedes a verb,
but also should also immediately precede a verb or verb phrase.
Option C: C Correct. This sentence structure makes
alcohol is the single subject of both verbs,
causes and
may increase. This structure directly and efficiently expresses the causal relationship between alcohol and the two effects and indicates that those effects are also causally related to each other.
Option D: Because the portion of the sentence following
but also is a grammatically complete structure with its own subject and predicate, it functions as an independent clause, but the absence of a comma after
accidents makes it unclear whether this is how it is intended. Since
not only immediately precedes a verb,
but also should also immediately precede a verb or verb phrase rather than a noun phrase. The placement of
especially and the absence of punctuation make the sentence ambiguous: does it mean
especially to the spinal cord,
especially injuries to the spinal cord, or
especially may be more severe?
Option E: Because the portion of the sentence following
but also is a grammatically complete structure with its own subject and predicate, it functions as an independent clause, but the absence of a comma after
accidents makes it unclear whether this is how it is intended. Since
not only immediately precedes a verb,
but also should also immediately precede a verb or verb phrase rather than a noun phrase. This sentence structure does not clearly tell why the increase is mentioned in relation to the information, in the first part of the sentence, about alcohol.
The correct answer is C.
Please note that I'm not the author of this explanation. I'm just posting it here since I believe it can help the community.