Clinical and Electrodiagnostic findings of n-Hexane Neuropathy

n-Hexane is an isomer of hexane and was identified as a peripheral neurotoxin in 1964. The solvents containing n-Hexane are used as cleaning agents in the printing, textile, furniture and shoemaking industries. Certain kinds of special glues used in the roofing, leather and shoe industries also contain n-hexane. Inhalation is the main route of occupational exposure. Symptoms of a sensorimotor type of neuropathy develops after a few months to a year of repeated overexposure to n-hexane. The first symptoms are sensory and consist of tingling, numbness, burning, or prickling sensations in the feet or toes. Usually there are mixed electrophysiological findings which include both axonal degeneration and demyelination. The neuropathology of n-hexane neuropathy is distinctive with axonal swelling and neurofilament accumulation. The only treatment is removal from n-hexane exposure and the prognosis is generally favorable. Recovery may take months to years. In Turkey n-Hexane is mostly used in the shoemaking industries, and neurotoxicity has been reported. We report 8 patients who were working in the same shoe/sandal manufacturer for a mean duration of 27 months (3 months-8 years). and presented with a subacute neuropathy. The mean age was 18 (16-22). All subjects had a subacute presentatian between 15 days and 3 months. Motor deficits were the main clinical manifestation, but the EMG study revealed a sensorimotor neuropathy in all patients. Delayed worsening of symptoms and signs after cessation of n-hexane exposure was observed in all cases. A sural nerve biopsy was done in 3 patients