Encephalopathy and Neuropathy due to Glue, Paint Thinner, and Gasoline Sniffing in Trinidad and Tobago-MRI Findings

Abstract

A 29-year-old male petrol station pump attendant was admitted with ataxia and clinical evidence of a sensorimotor polyneuropathy which developed over the preceding 3 months. He had cognitive dysfunction, hearing loss, and cerebellar clinical abnormalities that came on slowly over the three years. He had a fifteen-year history of sniffing mostly glue, occasionally paint thinners, and, in the recent two years, gasoline. Magnetic resonance brain imaging showed abnormalities of the cerebral cortex, cerebral white matter, corpus callosum, hippocampus, brainstem and cerebellar atrophy, hypointensities of basal ganglia, red nuclei, and substantia nigra as previously described in toluene sniffing. Abstinence for six months led to partial clinical improvement. Clinicians need to be aware of this preventable entity which has peculiar radiological findings which are being increasingly accepted as typical.

Default Mode Network Efficiency Is Correlated With Deficits in Inhibition in Adolescents With Inhalant Use Disorder

“…Time series of the fMRI data were decomposed on six levels using the maximum overlap discrete wavelet transform (MODWT), which allows signal decomposition at different resolution levels using the Daubechies least asymmetric wavelet filter (8). The decomposition was carried out with the R package brainwaver 1.6.…”

“…Several clinical investigations in adults, including those in subjects with chronic job-related industrial solvent exposure, have shown that chronic use of inhalants is associated with significant brain abnormalities. Among the most commonly reported effects are leukoencephalopathy (6,7) and atrophy of both the cerebellum and corpus callosum (8). It is worth mentioning that inhalants are commonly one of the earliest drugs used by adolescents, and a few authors have pointed out that such encephalopathies can be observed in young consumers (9,10).…”

Cyclohexane, a Potential Drug of Abuse with Pernicious Effects on the Brain

“…Solvent abuse can result in neurological disorders, including psychiatric diseases such as depression, anxiety, bipolar mood disorder, and addiction (Ridenour et al, 2007 ). The long-term exposure to organic solvents may also produce chronic encephalopathy, which is characterized by abnormalities in brain structures and cognitive dysfunction (Ramcharan et al, 2014 ).…”

“…Usually, commercial solvent abuse results in exposure to several volatile substances, such as toluene, n -hexane, xylene and benzene. This makes it difficult to study the neurotoxic effects of the individual constituents (Ramcharan et al, 2014 ). Therefore, researchers have to study the effects of each solvent to clarify their role in brain degeneration and neurological impairment.…”

“…Interestingly, a similar biphasic dose-response effect has been described in mice exposed to cyclohexane, and is associated with neurohistological changes (Campos-Ordonez et al, 2015 ). Furthermore, these volatile solvents produce dramatic structural changes in the brain, including atrophy of the cerebral cortex, white matter, corpus callosum, hippocampus, brainstem, cerebellum, basal ganglia, red nuclei, and substantia nigra (Fan et al, 2014 ; Ramcharan et al, 2014 ). Experimental models of toluene, 1-bromopropane, TCE and dichloromethane exposure have revealed the presence of astrocyte reactivity and a microglial response in the hippocampus, cerebellum, and cerebral cortex.…”