| Chronic Toxic Encephalopathy in a Painter Exposed to Mixed Solvents Robert G. Feldman,1,2
Marcia Hillary Ratner,1
and Thomas Ptak3
1Environmental and Occupational Neurology Program, Department of Neurology, Boston University School of Medicine, Boston, MA 02218 USA;
2Harvard School of Public Health, Boston, MA 02215 USA;
3Department of Radiology, Boston University School of Medicine, Boston, MA 02218 USA Abstract
This paper describes symptoms and findings in a 57-year-old painter who had been exposed to various organic solvents for over 30 years. He began to work as a painter at 16 years of age, frequently working in poorly ventilated areas ; he used solvents to remove paint from the skin of his arms and hands at the end of each work shift. The patient and his family noticed impaired short-term memory function and changes in affect in his early forties, which progressed until after he stopped working and was thus no longer exposed to paints and solvents. After the patient's exposures had ended, serial neuropsychological testing revealed persistent cognitive deficits without evidence of further progression, and improvement in some domains. Magnetic resonance imaging revealed global and symmetrical volume loss, involving more white than gray matter. The findings in this patient are consistent with chronic toxic encephalopathy and are differentiated from other dementing processes such as Alzheimer's disease, multi-infarct (vascular) dementia, and alcoholic dementia. Previous descriptions in the literature of persistent neurobehavioral effects associated with chronic exposure to organic solvents corroborate the findings in this case. Key words: cerebral atrophy, dementia, magnetic resonance imaging (MRI) , neuropsychological, solvents, toluene. Environ Health Perspect 107:417-422 (1999) . [Online 8 April 1999] http://ehpnet1.niehs.nih.gov/docs/1999/107p417-422feldman/ abstract.html Address correspondences to R.G. Feldman, Department of Neurology, Boston University School of Medicine, Room C-314, 715 Albany Street, Boston, MA 02118-2526 USA. Presented at the Clinical Pathological Correlation Lecture, Harvard School of Public Health, 25 September 1998. Received 14 December 1998 ; accepted 21 January 1999.
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