Signs of toluene abuse and addiction include the identification of paint stains on the body or clothing, a chemical breath odor, red eyes, nearby discarded spray paint cans or cans of solvent, and a drunken or dazed appearance (1). An individual with ear nerve damage and hearing loss has limited treatment options because this sort of damage can't be effectively treated with either medications or surgery, explains the University of California San Francisco Medical Center. COVID-19 is an emerging, rapidly evolving situation. BACKGROUND: Toluene was an organic compound used in chemical and drug industries, the main source of toluene emissions from fires. Laboratory testing for acute toluene toxicity is hampered by the fact that blood tests for toluene and urinary tests for hippuric acid are not available in most hospitals. It is also found in fuels. Inhalant abuse appears to be startlingly high among younger aged children, with up to 10% to 15% of young people in the United States having used inhalants in some surveys (2). Toluene abuse and white matter: a model of toxic leukoencephalopathy. Inhaled chemicals are rapidly absorbed through the lungs into the bloodstream and quickly circulated to the brain and other organs. Disorders of the muscles, cardiovascular effects, renal tubular damage, and sudden death have occurred in chronic abusers of toluene. Long-term and intense exposure to toluene vapors in humans who abuse spray paint and related substances has led to the recognition that toluene has a severe impact on central nervous system myelin. Author information: (1)Department of Occupational Health and Safety, Faculty of Public Health, … Although many questions about the toxic effects of inhalants in general are unresolved, the nervous system is clearly vulnerable to toxicity from these substances (4). Most inhaled toluene is metabolized in the liver by conversion to benzoic acid by two enzymes, alcohol dehydrogenase and aldehyde dehydrogenase (6). A second patient with a chronic encephalopathy due to gasoline sniffing reported in 1978 demonstrated cerebellar cortical atrophy (45). Use of Biodegradable, Chitosan-Based Nanoparticles in the Treatment of Alzheimer's Disease. At autopsy the brain showed cerebral and cerebellar atrophy and severe thinning of the corpus callosum. MTI is based on the interaction of protons in water and macromolecules in the brain using a radiofrequency saturation pulse delivered to the head. Nerve damage of this type has been found to … This will help in the speedy recovery of the damaged nerve. Toluene exposure can cause eye and nose irritation, fatigue, confusion, dizziness, enlarged pupils, anxiety, muscle fatigue, insomnia, nerve damage, skin inflammation, even liver and kidney damage. Clinical features of acute intoxication with toluene were first described in 1963 (11). Cyclohexane Inhalation Produces Long-Lasting Alterations in the Hippocampal Integrity and Reward-Seeking Behavior in the Adult Mouse. The level of exposure also depends on the dose, duration, and work done [ 6 ]. Although no data exist on long-term outcome in toluene abusers who abstain from inhalant abuse, our experience suggests that individuals may show partial recovery once the toxic effect of toluene is no longer present (21). However, nerve damage is very serious, and can be permanent. Damaged nerves can send your bladder faulty messages, so you feel like you have to pee a lot or have trouble making it to the restroom in time. Many of our patients have inhaled these vapors for decades, and it is not uncommon to see 50- and 60-year-old individuals still engaged in this dangerous practice. As with DTI, it is anticipated that MTI will prove useful in quantitating white matter damage in areas of NAWM. In contrast, Ikeuchi and Hirai investigated the effects of toluene on guinea pig hippocampal slices and found inhibition of synaptic transmission but no morphological abnormalities (56). In the 1980s, more comprehensive studies of selective toluene abusers appeared. In the 1980s, modern neuroimaging began to be regularly applied to the study of chronic toluene abusers. There are many surgical as well as non-surgical techniques for treating damaged nerve, which has been practiced since long in medical science. The clinical syndrome, toluene leukoencephalopathy, can be detected by a combination of characteristic symptoms and signs, detailed neurobehavioral evaluation, and brain magnetic resonance imaging. Recommendations apply only to National Institute for Occupational Safety and Health (NIOSH) approved respirators. Exactly when in the clinical course the damage becomes irreversible, an issue of paramount importance for prognostic counseling is unknown. 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. production is toluene. Long-term toluene abuse has led to neuropsychiatric and neurobehavioral disorders, which in many cases, but not all, were reversible. The insensitivity of standard MRI to mild degrees of toluene leukoencephalopathy hampers early detection of individuals at risk, and it is therefore possible that a crucial opportunity for effective intervention is lost. Nerve damage can make you lose feeling in your feet, so even minor cuts can turn into sores or ulcers without your realizing it. Indeed, the signature pathological feature, and perhaps the earliest morphological evidence of toluene leukoencephalopathy, seems to be the presence of astrocytosis and these perivascular PAS-positive macrophages containing coarse or laminar myelin debris, which can be found even in areas devoid of recognizable myelin damage (Fig. Your skin will also become numb. Chronic near lifetime toluene exposure in rodents does not replicate solvent abuse leukoencephalopathy in humans. Nerve damage can distort existing signals, create new signals, or prevent the usual signals from transferring. MRI also reveals a predilection for damage to the corpus callosum (Fig. A component of many paints, lacquers, glues, adhesives, inks, and cleaning fluids, toluene is also widely used as a cleaning and drying agent in the rubber and lumber industries, and in the dry cleaning, motor, aviation, and chemical industries (1). A significant and selective decline of the WAIS-Revised performance intelligence quotient (IQ), and in particular the digit symbol subtest, was reported among a group of solvent abusers who had diffuse cerebral white matter changes on MRI (23). More recent studies have also reported Purkinje cell loss and hippocampal neuronal loss in rats with inhalation exposure (55). Neurotmesis. 2C). Toluene abuse in pregnancy causes a constellation of teratogenic features known as fetal solvent syndrome, which is similar to the fetal alcohol syndrome. The symptoms depend on which nerves are affected. Graph theory analysis of the dopamine D2 receptor network in Parkinson's disease patients with cognitive decline. Knitting, typing, and tying your shoes may become difficult. The understanding of the chronic effects of toluene on the brain has evolved over the last four decades. A comparison of fetal alcohol syndrome, toluene embryopathy, and maternal phenylketonuria, Toluene embryopathy: Clinical delineation and developmental follow-up, Toluene embryopathy: Delineation of the phenotype and comparison with fetal alcohol syndrome, Solvent abuse in pregnancy: A perinatal perspective, Prenatal exposure to toluene results in abnormal neurogenesis and migration in rat somatosensory cortex. mononeuropathy – damage to a single nerve outside of the central nervous system ; In many cases, someone with peripheral neuropathy may have more than one of these types of peripheral neuropathy at the same time. Neurotoxicology. Although gliosis was not evident on the Holzer and phosphotungstic-acid-hematoxylin methods for glia available to us at the time of the report, recent reexamination of this case with immunostaining for glial fibrillary acidic protein (GFAP) demonstrated reactive gliosis even in cerebral white matter areas where myelin loss was undetectable. [A Case of Testicular Tumor with Multiple Metastasis Leading to Complete Response after Treatment Interruption]. However, effects such as incoordination, cognitive impairment, and vision and hearing loss may become permanent with repeated exposure, especially at concentrations associated with … A 1992 study of toluene concentrations in various brain regions in an autopsied case of a chronic abuser offered corroborative data that the corpus callosum was preferentially targeted and the cerebral cortex was spared, although no neuropathological features of this case were provided (42). However, the absorption of ingested toluene is slower than that of inhaled toluene. Formal evaluation of neurobehavioral function in one group of such patients documented widespread cognitive dysfunction with neuropsychological measures, including the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale (20). The … Clin Case Rep. 2020 Oct 27;8(12):3450-3457. doi: 10.1002/ccr3.3459. O n e case of reversible bilateral optic neuropathy has been reported after industrial exposure to vinyl benzene, however [ S ] . This extensive destruction of nerve fibers is clinically … There is no question that the leukoencephalopathy detected by conventional MRI scanning in chronic inhalant abusers represents the severe end of the spectrum of white matter injury, and is usually detected in individuals only after many years of heavy toluene abuse. In addition, substance abusers may have coexistent disorders such as acquired immunodeficiency syndrome, traumatic brain injury, hepatic cirrhosis, and nutritional deficiencies that impact neuropathological studies. Acute exposure causes fatigue, mild confusion, ataxia, and dizziness. Medical personnel do not regularly see many chronic toluene abusers and most abusers are notoriously poor historians, due in part to their encephalopathy. AJNR Am J Neuroradiol. 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