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Toxic polyneuropathies after sniffing a glue thinner

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Summary

In West Berlin in the autumn of 1975 through the following 5 months we observed 18 juvenile patients who had a toxic polyneuropathy and had sniffed a glue thinner. The neurological picture consisted of a symmetrical, progressive, ascending, mainly motor, polyneuropathy with pronounced muscle atrophy and characteristic vegetative alterations. The height of the disease was reached after 11/2–21/2 months and was characterized by tetraplegia in 7 patients. After 8 months all patients still had a motor deficit. Nerve biopsy showed paranodal axon swelling, dense masses of neurofilaments and secondary myelin retraction. The neurological and morphological data correspond to the “glue sniffer's neuropathy” and the n-hexane and MBK polyneuropathy after industrial exposure, as described in 10 cases to date. However, there was no MBK in the glue thinner. The polyneuropathies occurred in close time relation with the denaturation of the thinner with MEK (2-butanone). It is concluded from the data n-hexane and MBK have a common toxic mechanism with primary axonal changes and that there is an additional synergistic effect of MEK.

Zusammenfassung

Ab Herbst 1975 traten in West-Berlin innerhalb von fünf Monaten 18 Fälle toxischer Polyneuropathien bei Jugendlichen auf, die einen Klebstoffverdünner geschnüffelt hatten. Das neurologische Syndrom bestand in einer symmetrischen, progressiven, von distal aszendierenden, vorwiegend motorischen Polyneuropathie mit ausgeprägten Muskelatrophien und charakteristischen vegetativen Veränderungen. Der Höhepunkt der Erkrankung war nach 11/2 bis 21/2 Monaten erreicht und führte in 7 Fällen zu Tetraplegien; nach 8 Monaten waren noch bei allen Erkrankten motorische Aufälle vorhanden. Nervenbiopsien zeigten paranodal Axonanschwellungen, Verklumpung der Neurofilamente und sekundäre Myelinretraktionen. Neurologische und morphologische Daten entsprachen der bisher in 10 Fällen beschriebenen “glue sniffer's neuropathy” sowie den n-Hexan- und Methyl-Butyl-Keton (MBK)-Polyneuropathien nach industrieller Exposition. MBK war jedoch im Verdünner nicht enthalten. Die Polyneuropathien traten in direktem zeitlichen Zusammenhang mit der Vergällung des Verdünners mit Methyl-Ethyl-Keton (MEK) auf. Aus den Daten wird auf einen n-Hexan und MBK gemeinsamen Schädigungsmechanismus mit primär axonalem Angriffspunkt sowie einen zusätzlichen synergistischen Effekt des MEK geschlossen.

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References

  1. Allen, N., Mendell, J. R., Billmaier, D. J., Fontaine, R. E., O'Neil, J.: Toxic polyneuropathy due to methyl-n-butyl-Ketone. Arch. Neurol.32, 209–218 (1975)

    PubMed  CAS  Google Scholar 

  2. Altenkirch, H., Mager, J.. Polyneuropathien durch Schnüffeln von Pattex-Verdünner. DMW101, 195–198 (1976)

    CAS  Google Scholar 

  3. Assouly, M., Siou, G., Cavigneaux, A.: Polynévrites par n-hexane. Arch. Mal. Prof.33, 309–310 (1972)

    PubMed  CAS  Google Scholar 

  4. Bass, M.: Sudden sniffing death. JAMA212, 2075–2079 (1970)

    Article  PubMed  CAS  Google Scholar 

  5. Billmaier, D., Yee, H. T., Allen, N., Craft, B., Williams, N., Epstein, S., Fontaine, R.: Peripheral neuropathy in a coated fabrics plant. J. Occup. Med.16, 665–671 (1974)

    PubMed  CAS  Google Scholar 

  6. DiBosco, M., Fonzi, S.: La polineuropatia cosidetta da collanti o dei calzaturieri. Riv. Infort. Mal. Prof.61, 665–692 (1974)

    Google Scholar 

  7. Cargill, C.: Polynévrites dans l'industrie du cuir et de la chaussure toxicité du n-hexane. Thèse, Paris VII, 1972

  8. Collom, W. D., Winek, C. L.: Detection of glue constituents in fatalities due to glue sniffing. Clin. Toxicol.3, 125–130 (1970)

    Article  PubMed  CAS  Google Scholar 

  9. McDonough, J. R.: Possible neuropathy from methyl-n-butyl-Ketone. N. Engl. J. Med.290, 695 (1974)

    PubMed  CAS  Google Scholar 

  10. Duckett, S., Williams, N., Frances, S.: Peripheral neuropathy associated with inhalation of methyl-n-butyl-Ketone. Experientia30, 1283–1284 (1974)

    Article  PubMed  CAS  Google Scholar 

  11. Gamage, J. R., Zerkin, E. L.: Inhalation of volatile substances. Report series of National Clearinghouse for Drug Abuse. Information series30, No. 1, July 1974

  12. Gaultier, M., Rancruel, G.: Polynévrites et hydrocarbures aliphatiques. Eur. J. Toxicol.6, 294–296 (1973)

    CAS  Google Scholar 

  13. Gonzalez, E., Downey, J.: Polyneuropathy in a glue sniffer. Arch. Phys. Med.53, 333–337 (1972)

    PubMed  CAS  Google Scholar 

  14. Goto, I., Matsumura, M.: Toxic polyneuropathy due to glue sniffing. J. Neurol. Neurosurg. Psychiat.37, 848–853 (1974)

    Article  PubMed  CAS  Google Scholar 

  15. Grabski, D.: Toluene sniffing producing cerebellar degeneration. Am. J. Psychiat.118, 461–462 (1961)

    PubMed  CAS  Google Scholar 

  16. Herskowitz, A., Ishii, N., Schaumburg, H.: n-Hexane neuropathy. N. Engl. J. Med.285, 82–85 (1971)

    Article  PubMed  CAS  Google Scholar 

  17. v. Heuser, M.: Toluolsucht. Med. Klinik63, 1888–1890 (1968)

    CAS  Google Scholar 

  18. Ishii, N., Herskowitz, A., Schaumburg, H. H.: n-Hexane polyneuropathy: A clinical and experimental study. J. Neuropath. Exp. Neurol.31, 198 (1972)

    Google Scholar 

  19. Korobkin, R., Asbury, A. K.: Glue sniffing neuropathy. Arch. Neurol.32, 158–162 (1975)

    PubMed  CAS  Google Scholar 

  20. Kurita, H.: Experimental studies on the effects of n-Hexane to albino rats. Jap. J. Ind. Health9, 672–677 (1967)

    Google Scholar 

  21. Lukins, H. B., Foster, J. W.: Methyl Ketone metabolism in hydrocarbon-utilizing myco bacteria. J. Bacteriol.85, 1074–1087 (1963)

    PubMed  CAS  Google Scholar 

  22. Mallov, J. S.: MBK neuropathy among spray painters. JAMA234, 1455 (1976)

    Article  Google Scholar 

  23. Matsumura, M., Snoué, N., Ohnishi, A.: Toxic polyneuropathy due to glue sniffing. Clin. Neurol.12, 290–296 (1972)

    CAS  Google Scholar 

  24. Mendell, J. R., Saida, K., Ganasia, M. F.: Toxic polyneuropathy produced experimentally by methyl-n-butyl-Ketone. Science185, 787–789 (1974)

    PubMed  CAS  Google Scholar 

  25. Miyagaki, H.: An electrophysiological study on the toxicity of n-Hexane on the peripheral nerve. Jap. J. Ind. Health9, 660–671 (1967)

    Google Scholar 

  26. Musclow, C. E., Awen, C. F.: Glue sniffing: Report of a fatal case. CMA J.104, 315–318 (1971)

    CAS  Google Scholar 

  27. Reinhardt, C. F. et al.: Cardiac arrhythmias and aerosol sniffing. Arch. Environ. Health, Vol.22, 265 (1971)

    CAS  Google Scholar 

  28. Shirabe, T., Tsuda, T., Terao, A.: Toxic polyneuropathy due to glue sniffing (Report of two cases with alight and electronmicroscopic study of the peripheral nerves and muscles.) J. Neurol. Sci.21, 101–113 (1974)

    Article  PubMed  CAS  Google Scholar 

  29. Spencer, P. S., Schaumburg, H. H., Raleigh, R. L., Terhaar, C. J.: Nervous system degeneration produced by the industrial solvent methyl-n-butyl-Ketone. Arch. Neurol.32, 219–222 (1975)

    PubMed  CAS  Google Scholar 

  30. Steinke, M.: Über das Schnüffeln, eine Sonderform jugendlichen Rauschmittelmißbrauchs. Das Öffentl. Gesundheitswes.34, 703–707 (1972)

    CAS  Google Scholar 

  31. Suzuki, T., Shimbo, S., Nishitani, H., Oga, T., Imamura, T., Ikeda, M.: Muscular atrophy due to glue sniffing. Int. Arch. Arbeitsmed.33, 115–123 (1974)

    Article  PubMed  CAS  Google Scholar 

  32. Towfighi, J., Gonatas, N. K., Pleasure, D., Cooper, H., McCree, L.: Glue sniffer's neuropathy. Neurology26, 238–243 (1976)

    PubMed  CAS  Google Scholar 

  33. Viader, F., Lechevalier, B., Morin, R.: Polynévrite toxique chez un travailleur du plastique. Rôle possible du méthyl-éthyl-cétone. La nouvelle presse méd.4, No. 24, 1813–1814 (1975)

    CAS  Google Scholar 

  34. Wada, Y., Okamoto, S., Tagaki, S.: Intoxication polyneuropathy following exposure to n-Hexane. Clin. Neurol.5, 591–598 (1965)

    Google Scholar 

  35. Yamada, S.: An occurrence of polyneuritis by n-Hexane in the polyethylene laminating plants. Jap. J. Ind. Health6, 192 (1964)

    Google Scholar 

  36. Yamada, S.: Intoxication polyneuritis in the workers exposed to n-Hexane. Jap. J. Ind. Health9, 651–659 (1967)

    Google Scholar 

  37. Yamamura, Y.: n-Hexane polyneuropathy. Folia Psychiatr. Neurol. Jap.23, 45–57 (1969)

    CAS  Google Scholar 

  38. Schaumburg, H. H., Spencer, P. S.: Degeneration in central and peripheral nervous systems produced by pure n-hexane: An experimental study. Brain99, 183–192 (1976)

    PubMed  CAS  Google Scholar 

  39. Abdel-Rahman, M. S., Hetland, L. B., Couri, D.: Toxicity and metabolism of methyl n-butyl ketone. Am. Ind. Hyg. Assoc. J.37, 95–102 (1976)

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Neurologische Klinik und Poliklinik, Institut für Neuropathologie im Klinikum Steglitz und Institut für Rechtsmedizin der Freien Universität, Hindenburgdamm 30, D-1000, Berlin 45

    H. Altenkirch, J. Mager, G. Stoltenburg & J. Helmbrecht

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  1. H. Altenkirch
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  2. J. Mager
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  3. G. Stoltenburg
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  4. J. Helmbrecht
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Altenkirch, H., Mager, J., Stoltenburg, G. et al. Toxic polyneuropathies after sniffing a glue thinner. J Neurol 214, 137–152 (1977). https://doi.org/10.1007/BF02430351

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  • DOI: https://doi.org/10.1007/BF02430351

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