Samukawa Makoto, Ichihara Gaku, Oka Nobuyuki, Kusunoki Susumu
Department of Neurology, Kinki University Faculty of Medicine, Osaka, Japan.
Arch Intern Med. 2012 Sep 10;172(16):1257-60. doi: 10.1001/archinternmed.2012.3987.
Health hazard alerts to 1-bromopropane, an alternative to ozone layer-damaging organic solvents, have been issued by some countries. Herein, we report a new case of 1-bromopropane-induced neurotoxicity. A 43-year-old male industrial worker developed muscle weakness, pain, numbness, and gait disturbance. Neurological examination indicated sensory ataxic neuropathy associated with mild impairment of upper motor neurons. He had used 1-bromopropane as a cleaning agent for metal parts at his workplace without appropriate protection. The serum bromide level was elevated at the onset of clinical manifestations. Histopathologic examination of sural nerve biopsy showed axonal damage. Under the tentative diagnosis of 1-bromopropane toxicity, he was kept away from exposure to the solvent. This resulted in gradual improvement of symptoms, recovery of motor function, and resolution of sensory deficits. The diagnosis of 1-bromopropane neurotoxicity in this case was based on details of the work environment, the clinical course, and laboratory and pathologic findings. To our knowledge, this is the first report that describes nerve biopsy findings in a human case.
一些国家已发布对1-溴丙烷的健康危害警报，1-溴丙烷是一种可替代破坏臭氧层有机溶剂的物质。在此，我们报告一例新的1-溴丙烷所致神经毒性病例。一名43岁男性产业工人出现肌肉无力、疼痛、麻木和步态障碍。神经学检查表明存在感觉性共济失调性神经病变，并伴有上运动神经元轻度受损。他在工作场所使用1-溴丙烷作为金属部件的清洁剂，且未采取适当防护措施。临床表现出现时血清溴化物水平升高。腓肠神经活检的组织病理学检查显示轴突损伤。在初步诊断为1-溴丙烷中毒后，让他避免接触该溶剂。这使得症状逐渐改善、运动功能恢复以及感觉缺陷消失。该病例中1-溴丙烷神经毒性的诊断基于工作环境细节、临床病程以及实验室和病理学检查结果。据我们所知，这是第一份描述人类病例神经活检结果的报告。
