Lotti M, Becker C E, Aminoff M J
West J Med. 1982 Dec;137(6):493-8.
Neither clinical nor laboratory evaluation can distinguish occupational neuropathies from neuropathies due to other causes. A worker may suffer either from mechanical injury of individual nerves or from a toxic polyneuropathy that is usually axonal in type. A thorough occupational and environmental history and the recognition of clusters of cases are important in determining the diagnosis. Electrophysiologic studies are helpful in detecting neuropathies in patients who have been occupationally exposed to neurotoxins but have no symptoms. Prevention of occupational neuropathies depends on clinical vigilance, industrial hygiene surveys, biologic monitoring and periodic examination of workers exposed to neurotoxic chemicals. The development of more sophisticated methods of prevention and early detection of peripheral nerve involvement depend on understanding the mechanisms of action of toxins and the pathophysiology of the lesions they cause.
临床评估和实验室评估均无法区分职业性神经病与其他原因导致的神经病。工人可能遭受个别神经的机械性损伤，也可能患上通常为轴索性的中毒性多发性神经病。详尽的职业和环境病史以及对病例群的识别对于确诊至关重要。电生理研究有助于检测职业性接触神经毒素但无症状的患者是否患有神经病。职业性神经病的预防依赖于临床警觉、工业卫生调查、生物监测以及对接触神经毒性化学物质的工人进行定期检查。更先进的预防方法以及外周神经受累早期检测方法的发展取决于对毒素作用机制及其所致病变病理生理学的理解。
