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Industrial agents causing peripheral neuropathy
What are the most important industrial agents causing peripheral neuropathy?
Peripheral neuropathy arising from exposure to industrial agents is uncommon in the developed world.
1. Organophosphates
Found in insecticides, petroleum additives, and nerve gases, acute toxicity leads to cholinergic crisis. A length-dependent sensorimotor axonal neuropathy and possibly myelopathy can occur 7 to 10 days after exposure.
2. Ethylene oxide
After exposure to ethylene oxide in antifreeze, paints, or detergents, CNS depression, cardiopulmonary toxicity, and renal toxicity occur early followed by severe axonal distal polyneuropathy.
3. Hexacarbons ( n -hexane, methyl n -butyl ketone)
Exposure to this toxin occurs with industrial use of hexacarbon solvents or inhalant abuse (glue sniffing). High-level exposure, especially in glue sniffers, can result in a subacute motor neuropathy leading to quadriparesis mimicking GBS while chronic exposure normally presents as an axonal sensory neuropathy.
4. Acrylamide
Direct skin exposure or inhalation leads to a length-dependent sensory axonal neuropathy.
