Toxic Polyradiculoneuritis Following N-Hexane Intoxication: A Case Report and Literature Review

Introduction: Hexane is a highly neurotoxic solvent capable of triggering peripheral neuropathies upon inhalation, either due to dependency or industrial exposure. The first case was reported among industrial workers. We present a case of acute polyradiculoneuritis associated with N-Hexane. Case Report: A 28-year-old patient, addicted to N-Hexane (solvent), presented with ascending tetraparesis initially involving the lower limbs. Cerebrospinal fluid (CSF) analysis was normal. Electroneuromyography (ENMG) indicated severe sensorimotor demyelinating polyneuropathy predominantly affecting the lower limbs, consistent with toxic neuropathy. MRI findings supported diffuse toxic leukodystrophy. The condition progressed to respiratory impairment, requiring intubation and mechanical ventilation. Despite immunoglobulin therapy, the patient's condition deteriorated. Discussion: Diagnosing polyradiculoneuritis induced by N-Hexane remains challenging. Imaging and ENMG are crucial for diagnosis. Management primarily involves cessation of exposure. Limited evidence exists regarding the efficacy of immunoglobulins or plasmapheresis. Conclusion: This report highlights a rare and severe case of polyradiculoneuritis associated with N-Hexane, emphasizing awareness of its neurotoxic potential.