Progressive optic neuropathy and sensorineural hearing loss due to chronic glue sniffing.

Abstract

SUMMARY A 27-year-old male developed cerebral and cerebellar atrophy over a period of five years of extensive glue sniffing. He also developed bilateral optic atrophy with blindness and severe sensorineural hearing loss. Investigation failed to show any other cause for the visual or hearing loss. Peripheral polyneuropathy and central nervous system damage may follow chronic toluene toxicity, but these auditory and visual complications have not previously been described.The acute central nervous system symptoms after inhalation of doses of toluene, the major component of glue vapour, include headache, nausea, tinnitus, ataxia, and less commonly, confusion, erratic behaviour, visual hallucination and seizures. [1][2][3] Sudden death has occurred when physical exercise followed glue sniffing; the mechanism probably involves cardiac arrhythmia. Chronic toxicity has been associated with peripheral neuropathy,45 permanent encephalopathy,6 cerebellar dysfunction, '-8 and

Effects of occupational exposure to organic solvents and noise on hearing.

“…Toluene ototoxicity has been discus sed previously. Evidence indicating that toluene exposure affects hearing comes mainly from studies conducted with toluene abusers (21)(22)(23)(24) and animal s (8,(27)(28)(29)(30)(31). In rats toluene interacted synergistically with noise.…”

“…Evidence is also beginning to accumulate which suggests that an ototra umatic interaction may ex ist between noise and org an ic sol-ve nts. Data on the ototoxic effect s of solvents like tolu ene, xylene, and styr ene come mainl y fro m limited animal studies and ca se report s on subs tance abu sers (19)(20)(21)(22)(23)(24).…”

Inhalant Abuse

“…29,38 Other causes of morbidity and mortality are related to the specific volatile chemical(s) used, associated health risk behaviors, drug-drug interactions, or additional material(s) found in the various inhaled products. Toxic effects attributed to specific chemicals include an ichthyosis-like dermatitis on the extremities, 25 decreased visual acuity, 41,42 sensorineural hearing loss, 42 cardiomyopathy, 43 toxic hepatitis, 44 distal renal tubular acidosis, 45 metabolic acidosis, 46 leukemia, 47 and aplastic anemia. 48 There is evidence that tolerance, dependence, and withdrawal symptoms can occur, and reported morbidities also include toluene embryopathy and neonatal withdrawal.…”

Clinical and electrophysiological findings in three patients with toluene dependency

“…Thereafter Keane [6] reported on a patient with optic neuropathy due to chronic inhalation of toluene. Since then, toluene-opticoneuropathy has been demonstrated with [7][8][9] and without [3] VECP abnormalities.…”

“…In rare instances ocular disturbances have been produced [4]. Several authors have demonstrated abnormal visual evoked cortical potentials (VECPs) as a result of toluene inhalation [5][6][7][8][9], while only one report included abnormal electroretinogram (ERG) findings of a decreased b-wave [5]. To our knowledge, no report has included results of electrooculogram (EOG) studies.…”