Alcoholism in occupational neurology: diagnostic difficulties with special reference to the neurological syndromes caused by exposure to organic solvents.

Clinical syndromes caused by chronic exposure to organic solvents and by chronic abuse of alcohol share several common features. In practice, both develop insidiously usually through repeated episodes of acute intoxications. It is difficult to diagnose them at their early stages. Careful history taking which includes the occupational history and tests for possible non-neurologic signs of alcoholism are necessary for the correct diagnosis. Regular absenteeism, lack of efficiency at work and changing jobs often are typical features of alcohol abuse. Difficulties in obtaining an adequate history of the patient's drinking habits are readily apparent, and considerable efforts are required. One should remember that alcohol abuse by no means rules out the possible concomitant effects of chronic exposure to organic solvents. The inadequacy and insufficiency of human data on exposure to various solvents and the consumption of alcohol make it imperative that epidemiologic studies focus on these problems. Special emphasis should be paid to the proper selection of sensitive techniques for the early detection of health impairments due to the consumption of alcohol and exposure to organic solvents.