L'invention concerne la production de dérivés de toluène de la formule (I) où R? Sensory neuropathy. Patients with sufficiently severe cerebral white matter pathology can be expected to develop deficits in sustained attention, memory retrieval, visuospatial skills, frontal lobe function, and psychiatric status; in contrast, language, procedural memory, and extrapyramidal function are usually preserved (10, 26). The findings in the first case may well be due to damage from a combination of volatile solvents in the lacquer thinner (44), and the second case was attributed by the authors themselves to the toxic effects of organic lead in the gasoline (45). nom grammaire . On the basis of comparison with other disorders of cerebral white matter, this profile was considered to be consistent with what would be expected to result from diffuse white matter involvement (10). On light microscopy of Case 1, Luxol fast blue-periodic acid-Schiff (LFB-PAS) staining showed severe myelin loss especially around blood vessels. In contrast, the verbal IQ, a measure that more specifically reflects language function, was not associated with white matter changes (23). The severity of Halliday's case and Case 1 of Kornfeld et al (43) contrasts sharply with the several-fold milder, ill-defined myelin pallor and significantly fewer numbers of PAS-positive, CD68-positive macrophages seen in our original case (and in Case 2 of Kornfeld et al; Fig. A second patient with a chronic encephalopathy due to gasoline sniffing reported in 1978 demonstrated cerebellar cortical atrophy (45). Epub 2019 Oct 23. Beyond this generalization, however, animal studies have not been particularly helpful in elucidating the specific mechanisms of myelin damage noted in humans. Thus the correlation between the effects of a given inhalant such as toluene and its clinical and neuroradiological findings can be difficult in some patients. In an autopsy study of a patient who inhaled toluene … Polymers (Basel). Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Open Access Maced J Med Sci [Internet]. These results suggested a primary impact on sustained attention, speed of information processing and visuospatial skills, combined with relative sparing of language (23), a pattern consistent with previous neurobehavioral observations in toluene abuse (21). This extensive destruction of nerve fibers is clinically … Although toluene leukoencephalopathy is well documented in inhalant abusers, the potential of low-level occupational or household toluene exposure to cause brain damage is uncertain. Ask your doctor to recommend what other types of doctors, physicians, medical specialists, or other medical professionals should be part of the team for your medical issues. AJNR Am J Neuroradiol. production is toluene. Nerve Pain Progression. Coronal brain sections from the autopsy case presented by Dr. William Halliday represent the severe end of the spectrum of white matter damage due to toluene abuse, but nevertheless show rather subtle, ill-defined, patchy discoloration of the white matter of the occipital lobe (A), with more obvious involvement of the cerebellar hemisphere (B). Despite these animal studies, however, many questions regarding the specific effects of toluene on myelin and other cellular components of the CNS remain to be answered. Multiple sclerosis is a disease associated with extensive nerve damage. Despite these changes in astrocytic function, little has been described in the way of white matter changes in these models, save for the study by Gotohda et al that mentions “thinning” of the cerebellar white matter in toluene-exposed rats (55). Toluene is also used in the production of polymers used to make nylon, plastic soda bottles, and polyurethanes and for pharmaceuticals, dyes, cosmetic nail products, and the synthesis of organic chemicals. Chronic exposure may be more serious for … In the cerebral hemispheres, periventricular white matter appeared to be most affected, with better preservation of subcortical U-fibers (41). Refer to the NIOSH Pocket Guide to Chemical Hazards for more information. Because cerebral and cerebellar neurons were intact and axons were preserved in areas of myelin pallor, toluene was hypothesized to be a pure myelin toxin (41). Because toluene is also part of the glue used by paint huffers, it has been suggested as a potential cause of the neurotoxic syndrome observed in these individuals. Removal (amputation) of a toe, foot or even the lower leg may be necessary. That way you can reduce the likelihood of permanent damage. The clinical syndrome, toluene leukoencephalopathy, can be detected by a combination of characteristic symptoms and signs, detailed neurobehavioral evaluation, and brain magnetic resonance imaging. Toluene abusers with long-term, intense exposure are at risk for toluene leukoencephalopathy, a syndrome characterized by dementia, cerebellar ataxia, corticospinal tract dysfunction, brainstem signs, and cranial neuropathies. In addition, the degree of myelination that exists in the individual when inhalant abuse begins may play a role in host susceptibility to toluene leukoencephalopathy. In 1961, Grabski documented chronic cerebellar degeneration in a person who sniffed toluene for an extended period, and this individual was the first published case documenting persistent neurotoxicity from toluene (13). The first description of permanent encephalopathy from toluene dates from 1966, when the same patient reported by Grabski (13) was described as having developed emotional lability and frontal release signs after continued toluene abuse (14). 2A), and the cerebellar white matter (Fig. This causes inflammation and injury to the sheath and ultimately to the nerve fibers that it surrounds. CAL/OSHA PELs. As mentioned, this solvent, like many others, is highly lipophilic (1), and in laboratory animals toluene is preferentially distributed in lipid-rich regions of the brain (51). Oligodendrocytes were reduced in number but there was only a mild gliotic reaction. Many abusers attain the desired effects of inhalants by simply removing the lid of a can or tube and sniffing the fumes, or spraying the aerosolized mists into the mouth. The clinical syndrome, toluene leukoencephalopathy, can be detected by a combination of characteristic symptoms and signs, detailed neurobehavioral evaluation, and brain magnetic resonance imaging. Neuropathological examination shows cerebral and especially cerebellar myelin loss, perivascular macrophages stuffed with coarse or linear PAS-positive debris, and trilaminar inclusions by EM. Recovery from an injured or damaged nerve may take long time, but again it depends on the degree or severity of the nerve injury. However, the absorption of ingested toluene is slower than that of inhaled toluene. Toluene is retained somewhat longer in adipose tissue, where its half-life is 0.5 to 3 days (9). University of Colorado School of Medicine. As mentioned, this solvent, like many others, is highly lipophilic , and in laboratory animals toluene is preferentially distributed in lipid-rich regions of the brain . Nerve damage can make you lose feeling in your feet, so even minor cuts can turn into sores or ulcers without your realizing it. Figure 1 displays MRI scans from several different chronic toluene abusers and illustrates the range of atrophy and white matter abnormalities that can be detected. In the white matter, a low MTR indicates damage to myelin and axons from a wide variety of disorders, including MS (37) and ischemia (38). Female reproductive system damage and pregnancy loss . The selective damage to white matter caused by chronic toluene abuse has offered an unprecedented opportunity for behavioral neurologists to study the specific effects of cerebral white matter disorders on behavior. In recent decades the organic solvent toluene (methylbenzene) has emerged as one of the best-studied neurotoxins. It is well known that brain myelination is an ongoing process that continues at least through the second decade (26), and because inhalant abuse typically begins in the early teen or even pre-teen years (1), most toluene abusers encounter this white matter toxin at a time when their myelin is still forming and may be most vulnerable to its toxic effects. These individuals displayed a pattern of neurobehavioral deficits consisting of inattention, apathy, memory dysfunction, visuospatial impairment, and preserved language (21). This study was important because it identified abnormalities in the brains of individuals who abused toluene and were not acutely intoxicated when tested, but it was apparent from the early days of CT that this technique could not provide detailed information on the brain white matter (26). Animal and human research shows that most inhalants are extremely toxic. eCollection 2020 Dec. Molecules. 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