Feldman R G, Ratner M H, Ptak T
Environmental and Occupational Neurology Program, Department of Neurology, Boston University School of Medicine, Boston, MA 02218, USA.
Environ Health Perspect. 1999 May;107(5):417-22. doi: 10.1289/ehp.99107417.
This paper describes symptoms and findings in a 57-year-old painter who had been exposed to various organic solvents for over 30 years. He began to work as a painter at 16 years of age, frequently working in poorly ventilated areas; he used solvents to remove paint from the skin of his arms and hands at the end of each work shift. The patient and his family noticed impaired short-term memory function and changes in affect in his early forties, which progressed until after he stopped working and was thus no longer exposed to paints and solvents. After the patient's exposures had ended, serial neuropsychological testing revealed persistent cognitive deficits without evidence of further progression, and improvement in some domains. Magnetic resonance imaging revealed global and symmetrical volume loss, involving more white than gray matter. The findings in this patient are consistent with chronic toxic encephalopathy and are differentiated from other dementing processes such as Alzheimer's disease, multi-infarct (vascular) dementia, and alcoholic dementia. Previous descriptions in the literature of persistent neurobehavioral effects associated with chronic exposure to organic solvents corroborate the findings in this case.
本文描述了一名57岁画家的症状和检查结果，该画家接触各种有机溶剂超过30年。他16岁开始当画家，经常在通风不良的区域工作；每次工作结束时，他都用溶剂清除手臂和手部皮肤上的油漆。患者及其家人在其40岁出头时注意到其短期记忆功能受损和情感变化，这种情况一直持续到他停止工作、不再接触油漆和溶剂之后。在患者停止接触后，系列神经心理学测试显示存在持续的认知缺陷，但无进一步进展的证据，且某些方面有所改善。磁共振成像显示全脑和对称性体积缩小，白质受累多于灰质。该患者的检查结果符合慢性中毒性脑病，与其他痴呆过程如阿尔茨海默病、多梗死（血管性）痴呆和酒精性痴呆相鉴别。文献中先前关于慢性接触有机溶剂相关的持续性神经行为影响的描述证实了本病例的检查结果。
