Recognizing neurotoxic disease.
Neurology 1987 Feb; 37(2):276-278
Several features of neurotoxic disease which assist in rendering a correct diagnosis were reviewed. Only rarely do neurotoxic chemicals destroy focal areas of the central nervous system (CNS) or peripheral nervous system (PNS). Signs and symptoms usually mimic metabolic, degenerative, nutritional, and demyelinating diseases. CNS imaging has been most useful for ruling out other conditions. Laboratory tests do not exist for determining the body burden of many neurotoxins and few neurotoxins are retained in the body for significant periods of time. There are few idiosyncratic variations in human responses to neurotoxic substances. Exposure to different levels of the same substance may result in a dramatically different clinical picture. Neurotoxic illness usually occurs concurrent with exposure or following a short latency period. The effects generally disappear after removal from exposure. The neurotoxic potential of a substance usually cannot be reliably predicted by its chemical formula. An agent without known neurotoxic activity may enhance the toxicity of a known neurotoxin that is present at a no effect level. Asymptomatic toxic disease of the nervous system occurs and may be widespread with such a modest decline in performance of the individual as to pass unnoticed. A focused history is the cornerstone of the neurotoxicology clinical evaluation. The occupational history should focus on habits, health of peers, improvement of symptoms on weekends or holidays, and conditions of the workplace.
NIOSH-Publication; NIOSH-Grant; Neurotoxic-effects; Nervous-system-disorders; Clinical-diagnosis; Diagnostic-techniques; Toxic-effects
Neuroscience Albert Einstein College 1410 Pelham Parkway Bronx, NY 10461
Neurotoxic Disorders; Neurotoxic-effects
Yeshiva University, New York, New York