Misirli H, Domaç F M, Somay G, Araal O, Ozer B, Adigüzel T
Haydarpafla Numune Training and Research Hospital, Department of 1st Neurology, Istanbul, Türkiye.
Electromyogr Clin Neurophysiol. 2008 Mar;48(2):103-8.
Chronic exposure to relatively high levels of n-hexane either by inhalation or skin contact can result in peripheral nerve lesions. We present the clinical and electrophysiological features of 5 patients who have been exposed to n-hexane at similar industrial occupations in the progressive phase.
All patients underwent routine laboratory tests, cerebrospinal fluid examination, and sural nerve biopsy. Conventional sensory and motor nerve conduction studies were applied at admission and at the end of the 12 month.
The average incubation period of the 5 cases was 10.2 months and the average period of the initial symptoms was 3.8 months. Numbness and weakness of the lower extremities were the initial symptoms that had ascended to the upper extremities in three of the patients. Deep tendon reflexes were either diminished or abolic. There was distal atrophy only in patient 5. All were treated with vitamin B complex and physical therapy and training. They were removed from further exposure to n-hexane after aetiological confirmation, but motor disturbance continued to worsen in the patient 5. The patients were visited every 3 months. Sensory functions were regained earlier than motor functions. All the patients, including one who was severe quadriparetic in the early stages, regained their full motor capabilities within 6 months to 21 months.
Occupational n-hexane causes subacute neuropathy and the duration of exposure is important for the neurological outcome. We suggest that the prognosis of n-hexane induced neuropathy is well if correct diagnosis is made and further exposure is ceased.
长期通过吸入或皮肤接触相对高浓度的正己烷可导致周围神经病变。我们报告了5例在进展期因从事类似工业职业而接触正己烷患者的临床和电生理特征。
所有患者均接受了常规实验室检查、脑脊液检查和腓肠神经活检。在入院时和12个月结束时进行了常规感觉和运动神经传导研究。
5例患者的平均潜伏期为10.2个月,初始症状的平均持续时间为3.8个月。下肢麻木和无力是初始症状,其中3例患者的症状已向上肢发展。深腱反射减弱或消失。仅患者5出现远端萎缩。所有患者均接受了复合维生素B治疗以及物理治疗和训练。在病因确诊后,他们不再接触正己烷,但患者5的运动障碍持续恶化。每3个月对患者进行一次随访。感觉功能的恢复早于运动功能。所有患者,包括1例早期严重四肢瘫患者,均在6个月至21个月内恢复了全部运动能力。
职业性正己烷可导致亚急性神经病变,接触持续时间对神经学结局很重要。我们认为,如果能做出正确诊断并停止进一步接触,正己烷所致神经病变的预后良好。