Polyneuropathie und Enzephalopathie durch organische Lösungsmittel und Lösungsmittelgemische

Abstract

Solvent induced polyneuropathy and encephalopathy have been acknowledged quite recently as occupational diseases in Germany. For compensation first of all the diagnosis has to be proven. For differential diagnosis other known causes as well as non-organic mental diseases must be taken into consideration. The causality between proven exposures and diagnosed disease has at least to be probable. To evaluate causation extensive experience of the experts is needed. In this context scientific criteria regarding neurotoxicity of the solvent, duration of exposure, individual aspects of non-occupational influences, time course of the disease are important within a through synoptic evaluation. Possibilities and limitations of sensitive diagnostic measures such as neurographic, neuropsychologic and neuroimaging examinations are discussed. The prognosis of toxic polyneuropathy and encephalopathy is in general favorable if exposure has stopped. Additionally, adequate therapy and rehabilitation measures are supportive for a good prognosis.

Longitudinal Study to Explore Chronic Neuropsychologic Effects on Solvent Exposed Workers

“…It must be stated, that according to reference values the absolute differences in the neuropsychological test results between the different exposure groups are minor and have no meaning with respect to clinical occupational medicine 22,23) . According to the workers anamnesis the solvent-exposure in the past was probably higher than nowadays.…”

Methoden und Qualitätssicherung in der Umweltmedizin

“…Auch die durch Langzeiteinwirkung von neurotoxischen Stoffen, etwa Lösungsmitteln, bedingte toxische Enzephalopathie geht mit auffälligen, aber nicht sonderlich spezifischen PET-und SPECT-Mustern einher [29,30,31]. Die genannten bildgebenden Verfahren sind in der neuromedizinischen Forschung unstrittig von Nutzen.…”