Zhonghua Nei Ke Za Zhi. 2001 May; 40(5): 329-31.

[A clinical analysis of 102 cases of chronic n-hexane intoxication]

Kuang S, Huang H, Liu H, Chen J, Kong L, Chen B.

Guangdong Provincial Prevention and Treatment Center for Occupational Diseases, Guangzhou 510300, China.

OBJECTIVE: Chronic n-hexane exposure can result in n-hexane intoxication which is mainly characterized by a series of manifestations of peripheral nerve lesions. The disease was sometimes misdiagnosed as "unknown multiple peripheral neuropathy". 102 cases of n-hexane intoxication were investigated and reported in order to call attention to the disease. METHODS: All the 102 cases, male 30, female 72; age 17 - 29, mean (21 +/- 3) were n-hexane workers. During the hospitalization the following data were collected: medical history, neurological check up, electromyogram, electrocardiogram, serum biochemical analysis, opthalmologic study and the metabolite of n-hexane- the urinary 2, 5-hexanedione level. The airborne n-hexane levels of the working environment were also measured. RESULTS: The average incubation period of the 102 cases was (8.3 +/- 2.6) months. The average course of the disease was (12.1 +/- 4.2) months. Airborne n-hexane concentration of the working places ranged from 188.0 to 7,848.6 mg/m(3). The most common prodromes were headache, anorexia, dizziness and weight loss. The main clinical manifestations of the disease were ascending abnormal sensation. Sensory loss and dyskinesia began from the distant parts of the limbs. The patient had reduction or disappearance of tendon reflexes, weakness and muscle atrophy in the limbs. Electromyography showed a neuropathic pattern, which was parallel to the clinical symptoms and signs. Delayed worsening of symptoms and signs after cessation of n-hexane exposure was observed in some cases. All the 102 cases recovered totally after treatment with Vitamin B, Chinese traditional medicine, physical therapy and training. CONCLUSION: The main lesion of the disease is multiple peripheral neuropathy. Diagnosis should be made according to the history of n-hexane exposure, the typical clinical manifestations of peripheral neuropathy as well as the neuropathic changes on electromyography. Therapeutic measures for peripheral neuropathy of other etiologies may be used and the prognosis is optimistic if correct diagnosis is made and further exposure stopped.