Giant axonal swelling in "huffer's" neuropathy.

A young man with a long history of "huffing" of lacquer thinner developed toxic peripheral neuropathy. Clinical improvement occurred several weeks after cessation of exposure. Substantial slowing in nerve conduction was noted. Sural nerve biopsy specimen showed (1) giant axonal swelling, (2) axonal degeneration, and (3) an increased paranodal gap. We believe that "huffer's" neuropathy is a primary axonal neuropathy with secondary demyelination.