Polyneuropathies from solvents

Abstract

Polyneuropathy is a clinically diagnosed disorder. The diagnostic features consist mainly of subjective complaints about distally marked paresthesia or dysaesthesia, pain and motor disturbances like cramps. Neurological examination typically shows weak or absent tendon reflexes (early signs: weak or absent Achilles tendon reflexes), distally marked disturbances of sensitivity (early sign: reduced sense of vibration), atrophic paresis, cranial nerve impairment and disturbances of the autonomic nervous system. Results of additionally performed electrophysiological examinations (nerve conduction studies, vibratometry and thermotesting) contribute to the diagnosis. Polyneuropathy is undoubtedly induced by carbon disulfite, ethylene glycol, n-hexane and methyl-n-butylketone, triorthocresyl phosphate and solvent mixtures. Induction of polyneuropathy is doubtful with the following substances: tetrachloride, trichlorethylene, styrene, toluene. Additional impairment of the central nervous system is often indicated by clinical findings of brisk patellar tendon reflexes or the occurrence of Babinski's sign.