Toxic polyneuropathy of shoe workers in Italy. A clinical, neurophysiological and follow-up study

Abstract

Cases of polyneuropathy due to exposure to industrial solvents have been studied at several shoe factories in the province of Siena. After the screening of 654 employees 98 verified cases were detected. Of these, 16 were rated as moderate to severe, 45 as mild, and 37 were minimally involved but with characteristic electrodiagnostic abnormalities. Follow-up study in 53 patients showed that neurological signs and symptoms as well as electrodiagnostic abnormalities continued for years in several patients. In addition, after a year's observation, some patients showed signs of central nervous system dysfunction such as spasticity of the lower limbs and increased deep tendon reflexes. High percentages of commercial n-hexane were found in all the samples of glues and solvents collected from home-workers and from factories where cases of polyneuropathy occurred.

n-Hexane intoxication in a Chinese medicine pharmaceutical plant: a case report

“…CNS conduction abnormalities can be detected in evoked potential studies, or assessed by calculating transcranial magnetic stimulation and spinal nerve root stimulation [21, 22]. Some patients revealed signs of CNS dysfunction such as spasticity of the lower limbs and increasing deep tendon reflexes [23]. Our patient had typical clinical presentations and electrophysiological abnormalities, but without evidence of CNS involvement.…”

Solvent neurotoxicity

“…The most researched agent is n-hexane (the n stands for ''normal'' hexane to distinguish it from the isoforms of hexane, 3-methyl pentane, 2-methyl pentane, and 2,3-methyl butane) which has been associated with outbreaks of peripheral neuropathy in furniture manufacture, 60 printers, 61 and shoe makers. 62 Methyl n-butyl ketone was shown to be neurotoxic following an outbreak of peripheral neuropathy in an Ohio textile printing plant. 63 Subsequent animal studies showed that n-hexane and methyl n-butyl ketone share a common neurotoxic metabolite, 2,5-hexanedione.…”

Clinical, socio‐demographic, neurophysiological and neuropsychiatric evaluation of children with volatile substance addiction

“…1981). General concept is that peripheral neuropathy is caused by n‐hexane and its metabolites contained in volatile substances (Passero et al . 1983, Jalil & Vergara 1990).…”