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Journal of Neurology

, Volume 246, Issue 3, pp 198–206 | Cite as

Parkinsonism, pyramidal signs, polyneuropathy, and cognitive decline after long-term occupational solvent exposure

  • G. Hageman
  • J. A. F. van der Hoek
  • M. S. E. van Hout
  • Gert van der Laan
  • Ernst Jansen Steur
  • W. I. de Bruin
  • Karl Herholz
Original communication

Abstract

It is well known that exposure to manganese, solvents, or carbon monoxide in an occupational setting may lead to central nervous system damage and parkinsonism. The most important solvents in this respect are methanol, toluene, carbon disulfide, and n-hexane. We describe three patients who had been exposed to various solvents for more than 20 years (25, 34, and 46 years). They presented with parkinsonism, pyramidal signs, mild cognitive decline, and unresponsiveness to levodopa. Two patients had a predominantly axonal and sensory polyneuropathy of the lower legs with fasciculations in one of them. Parkinsonian features were progressive, even after the patients had stopped work. We present clinical data, neuropsychological findings, and results of brain computed tomography or magnetic resonance imaging, electroneuromyography, evoked potentials, single photon emission computed tomography, and positron-emission tomography. There is growing evidence that various organic solvents give rise to a parkinsonism syndrome with pyramidal features in susceptible individuals.

Key words Parkinsonism Solvents Neurotoxicity Occupational disease Chronic toxic encephalopathy 

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Copyright information

© Steinkopff Verlag 1999

Authors and Affiliations

  • G. Hageman
    • 1
  • J. A. F. van der Hoek
    • 2
  • M. S. E. van Hout
    • 3
  • Gert van der Laan
    • 5
  • Ernst Jansen Steur
    • 1
  • W. I. de Bruin
    • 4
  • Karl Herholz
    • 6
  1. 1.Department of Neurology, Medical Spectrum Twente, Hospital Enschede, P.O. Box 50000, 7500 KA Enschede, The Netherlands Tel.: +31-53-4872850 Fax: +31-53-4872882NL
  2. 2.Department of Neurology, Medical Spectrum Twente, Hospital Enschede, P.O. Box 50000, 7500 KA Enschede, and Coronel Institute, Dutch Center for Occupational Diseases, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The NetherlandsNL
  3. 3.Department of Clinical Psychology, Medical Spectrum Twente, Hospital Enschede, P.O. Box 50000, 7500 KA Enschede, The NetherlandsNL
  4. 4.Department of Nuclear Medicine, Medical Spectrum Twente, Hospital Enschede, P.O. Box 50000, 7500 KA, Enschede, The NetherlandsNL
  5. 5.Coronel Institute, Dutch Center for Occupational Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsNL
  6. 6.Department of Neurology and Psychiatry, Laboratory of PET, Max Planck Institute, University Hospital of Cologne, D-50924 Cologne, GermanyDE

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