Toxic polyneuropathy of shoe-industry workers. A study of 122 cases

The toxic polyneuropathy observed in a group of shoe-industry workers in Italy was clinically characterised by a symmetrical prevalently distal motor deficit, with occasional marked weakness of pelvic girdle muscles, and frequently by only subjective sensory symptoms; non-specific disturbances usual...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1976-12, Vol.39 (12), p.1151-1161
Main Authors: Cianchetti, C, Abbritti, G, Perticoni, G, Siracusa, A, Curradi, F
Format: Article
Language:English
Subjects:
Adolescent
Adult
Electroencephalography
Electromyography
Female
Humans
Hydrocarbons - adverse effects
Male
Middle Aged
Neural Conduction
Neuromuscular Diseases - chemically induced
Neuromuscular Diseases - diagnosis
Occupational Diseases
Peroneal Nerve
Shoes
Time Factors
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Summary:The toxic polyneuropathy observed in a group of shoe-industry workers in Italy was clinically characterised by a symmetrical prevalently distal motor deficit, with occasional marked weakness of pelvic girdle muscles, and frequently by only subjective sensory symptoms; non-specific disturbances usually preceded neurological signs. Subclinical cases of 'minimal' chronic neuropathy, characterised by alterations of a neurogenic type in the EMG without a reduction of motor nerve conduction velocity, were also observed. Worsening of the clinical picture, with further lowering of nerve conduction velocity, was noted in some cases up to four months after removal from the toxic environment. In the most severe cases clinical recovery took up to three years. The electromyographic and electroneurographic features were consistent with a mixed axonal neuropathy, with clear prevalence of the damage in the distal part of the nerve (dying-back neuropathy). Volatile substances, such as n-hexane and other low boiling point hydrocarbons found in high percentage in solvents and glues, are suggested as the causative agent.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.39.12.1151