N-hexane neuropathy: more frequent than expected

Organic solvents that are widely used in industrial production and abused amongst teenagers for recreational purposes may cause some neurological abnormalities including polyneuropathy. Poorly ventilated working environments and working without protective garments are the most common reasons of intoxication. N-hexane toxicity often causes sensorimotor mixed type demyelinating neuropathy, but axonal degeneration is not rare. We report five cases that had mainly axonal motor polyneuropathy due to n-hexane containing glue usage, with clinical and electrophysiological data. Clinical and electrophysiological examinations revealed predominantly motor findings. One patient had delayed P100 potential, two had abnormal conduction in fasciculus gracilis. “Coasting” phenomenon was observed in one patient. Neuropathy due to toxic agents is an important public health problem. Working place conditions must be strictly controlled if toxic materials are present. Patients who had electromyography compatible with polyneuropathy should be questioned for toxic exposure. Asymptomatic workers should also be examined. Patients should be followed for the possibility of “coasting” effect.