N-Hexane neuropathy: from addiction to disability!

Abstract

Introduction

Voluntary poisoning with neurotoxic products in order to achieve euphoria is common especially among young people. Neurological complications are quite likely and can be serious and irreversible.

Objectives

We aim to describe the peripheral neuropathies secondary to N-Hexane intoxication in a Tunisian population.

Methods

A retrospective descriptive study was carried out in our department of neurology in the NationalInstitute of Neurology of Tunis including patients diagnosed with N-Hexane neuropathy. All patientshad a history of a N-Hexane exposure. The diagnosis was confirmed after excluding other etiologiesthrough appropriate investigations. Clinical and para-clinical data as well as follow-up were assessed.

Results

We selected 38 patients with a mean age of 22.7 years [14-36]. Among them, 37 were glue-sniffer and 1 had a voluntary toxic exposure to paint. An associated cannabis consumption was found in 6 patients. All of them had a low socio-economic background and 17 were unemployed. Time to onset of neurological signs ranged from 5 months to 11 years. The clinical exam showed a quadriparesis (15,7%), a paraparesis (58%), sensory involvement (55,2%) amyotrophy (40%) and abolished tendon reflexes in lower limbs (81,5%). Swallowing disorder and optic neuritis were found in one case. The electroneuromyogram revealed an axono-demyelinating sensory-motor polyneuropathy (PN) in 16 cases and a demyelinating motor PN in 9 cases. Vitamin therapy, motor rehabilitation and psychotherapy sessions have been indicated. Only 6 patients showed slight clinical improvement after withdrawal. The rest of our patients did not quit; 84% of them became bedridden.

Conclusions

Glue-sniffer related neuropathy is very common in our country especially in adolescents and young adults with low socio-economic background. The neurological outcome is serious and usually irreversible if exposure is persistent.

Disclosure of Interest

None Declared