Skip to main content
The Yale Journal of Biology and Medicine logoLink to The Yale Journal of Biology and Medicine
. 1987 Mar-Apr;60(2):179–186.

Occupational neurology.

R G Feldman
PMCID: PMC2590302  PMID: 3577214

Abstract

The nervous system is vulnerable to the effects of certain chemicals and physical conditions found in the work environment. The activities of an occupational neurologist focus on the evaluation of patients with neurological disorders caused by occupational or environmental conditions. When one is making a differential diagnosis in patients with neurological disorders, the possibility of toxic exposure or encounters with physical factors in the workplace must not be overlooked. Central to an accurate clinical diagnosis is the patient's history. A diagnosis of an occupational or environmental neurological problem requires a careful assessment of the clinical abnormalities and confirmation of these disabilities by objective tests such as nerve conduction velocity, evoked potentials, electroencephalogram, neuropsychological batteries, or nerve biopsy. On the basis of information about hazards in the workplace, safety standards and environmental and biological monitoring can be implemented in the workplace to reduce the risks of undue injury. Clinical manifestations of headache, memory disturbance, and peripheral neuropathy are commonly encountered presentations of the effects of occupational hazards. Physicians in everyday clinical practice must be aware of the signs and symptoms associated with exposure to possible neurotoxins and work methods. Occupational and environmental circumstances must be explored when evaluating patients with neurologic disorders.

Full text

PDF
183

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armstrong T. J., Chaffin D. B. Carpal tunnel syndrome and selected personal attributes. J Occup Med. 1979 Jul;21(7):481–486. [PubMed] [Google Scholar]
  2. Axelson O., Hane M., Hogstedt C. A case-referent study on neuropsychiatric disorders among workers exposed to solvents. Scand J Work Environ Health. 1976 Mar;2(1):14–20. doi: 10.5271/sjweh.2826. [DOI] [PubMed] [Google Scholar]
  3. Baker E. L., Feldman R. G., White R. A., Harley J. P., Niles C. A., Dinse G. E., Berkey C. S. Occupational lead neurotoxicity: a behavioural and electrophysiological evaluation. Study design and year one results. Br J Ind Med. 1984 Aug;41(3):352–361. doi: 10.1136/oem.41.3.352. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Billmaier D., Allen N., Craft B., Williams N., Epstein S., Fontaine R. Peripheral neuropathy in a coated fabrics plant. J Occup Med. 1974 Oct;16(10):665–671. [PubMed] [Google Scholar]
  5. Cavanagh J. B., Fuller N. H., Johnson H. R., Rudge P. The effects of thallium salts, with particular reference to the nervous system changes. A report of three cases. Q J Med. 1974 Apr;43(170):293–319. [PubMed] [Google Scholar]
  6. Chhuttani P. N., Chawla L. S., Sharma T. D. Arsenical neuropathy. Neurology. 1967 Mar;17(3):269–274. doi: 10.1212/wnl.17.3.269. [DOI] [PubMed] [Google Scholar]
  7. Cianchetti C., Abbritti G., Perticoni G., Siracusa A., Curradi F. Toxic polyneuropathy of shoe-industry workers. A study of 122 cases. J Neurol Neurosurg Psychiatry. 1976 Dec;39(12):1151–1161. doi: 10.1136/jnnp.39.12.1151. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Feldman R. G., Goldman R., Keyserling W. M. Classical syndromes in occupational medicine. Peripheral nerve entrapment syndromes and ergonomic factors. Am J Ind Med. 1983;4(5):661–681. doi: 10.1002/ajim.4700040508. [DOI] [PubMed] [Google Scholar]
  9. Feldman R. G., Ricks N. L., Baker E. L. Neuropsychological effects of industrial toxins: a review. Am J Ind Med. 1980;1(2):211–227. doi: 10.1002/ajim.4700010212. [DOI] [PubMed] [Google Scholar]
  10. Feldman R. G., White R. F., Currie J. N., Travers P. H., Lessell S. Long-term follow-up after single toxic exposure to trichloroethylene. Am J Ind Med. 1985;8(2):119–126. doi: 10.1002/ajim.4700080206. [DOI] [PubMed] [Google Scholar]
  11. Fullerton P. M. Chronic peripheral neuropathy produced by lead poisoning in guinea-pigs. J Neuropathol Exp Neurol. 1966 Apr;25(2):214–236. doi: 10.1097/00005072-196604000-00003. [DOI] [PubMed] [Google Scholar]
  12. GILBERT G. J., GLASER G. H. Neurologic manifestations of chronic carbon monoxide poisoning. N Engl J Med. 1959 Dec 10;261:1217–1220. doi: 10.1056/NEJM195912102612404. [DOI] [PubMed] [Google Scholar]
  13. GRABSKI D. A. Toluene sniffing producing cerebellar degeneration. Am J Psychiatry. 1961 Nov;118:461–462. doi: 10.1176/ajp.118.5.461. [DOI] [PubMed] [Google Scholar]
  14. Hane M., Axelson O., Blume J., Hogstedt C., Sundell L., Ydreborg B. Psychological function changes among house painters. Scand J Work Environ Health. 1977 Jun;3(2):91–99. doi: 10.5271/sjweh.2785. [DOI] [PubMed] [Google Scholar]
  15. Hänninen H., Eskelinen L., Husman K., Nurminen M. Behavioral effects of long-term exposure to a mixture of organic solvents. Scand J Work Environ Health. 1976 Dec;2(4):240–255. doi: 10.5271/sjweh.2805. [DOI] [PubMed] [Google Scholar]
  16. Jenkins R. B. Inorganic arsenic and the nervous system. Brain. 1966 Sep;89(3):479–498. doi: 10.1093/brain/89.3.479. [DOI] [PubMed] [Google Scholar]
  17. Knave B., Olson B. A., Elofsson S., Gamberale F., Isaksson A., Mindus P., Persson H. E., Struwe G., Wennberg A., Westerholm P. Long-term exposure to jet fuel. II. A cross-sectional epidemiologic investigation on occupationally exposed industrial workers with special reference to the nervous system. Scand J Work Environ Health. 1978 Mar;4(1):19–45. doi: 10.5271/sjweh.2725. [DOI] [PubMed] [Google Scholar]
  18. Knox J. W., Nelson J. R. Permanent encephalopathy from toluene inhalation. N Engl J Med. 1966 Dec 29;275(26):1494–1496. doi: 10.1056/NEJM196612292752608. [DOI] [PubMed] [Google Scholar]
  19. Mena I., Marin O., Fuenzalida S., Cotzias G. C. Chronic manganese poisoning. Clinical picture and manganese turnover. Neurology. 1967 Feb;17(2):128–136. doi: 10.1212/wnl.17.2.128. [DOI] [PubMed] [Google Scholar]
  20. Ota M. Ultrastructure of sural nerve in a case of arsenical neuropathy. Acta Neuropathol. 1970;16(3):233–242. doi: 10.1007/BF00687363. [DOI] [PubMed] [Google Scholar]
  21. Papp J. P., Gay P. C., Dodson V. N., Pollard H. M. Potassium chloride treatment in thallotoxicosis. Ann Intern Med. 1969 Jul;71(1):119–123. doi: 10.7326/0003-4819-71-1-119. [DOI] [PubMed] [Google Scholar]
  22. SCHULER P., OYANGUREN H., MATURANA V., VALENZUELA A., CRUZ E., PLAZA V., SCHMIDT E., HADDAD R. Manganese poisoning; environmental and medical study at a Chilean mine. Ind Med Surg. 1957 Apr;26(4):167–173. [PubMed] [Google Scholar]
  23. Seppäläinen A. M., Husman K., Mårtenson C. Neurophysiological effects of long-term exposure to a mixture of organic solvents. Scand J Work Environ Health. 1978 Dec;4(4):304–314. doi: 10.5271/sjweh.2695. [DOI] [PubMed] [Google Scholar]
  24. Seppäläinen A. M., Härkönen H. Neurophysiological findings among workers occupationally exposed to styrene. Scand J Work Environ Health. 1976 Sep;2(3):140–146. doi: 10.5271/sjweh.2810. [DOI] [PubMed] [Google Scholar]
  25. Spencer P. S., Peterson E. R., Madrid R., Raine C. S. Effects of thallium salts on neuronal mitochondria in organotypic cord-ganglia-muscle combination cultures. J Cell Biol. 1973 Jul;58(1):79–95. doi: 10.1083/jcb.58.1.79. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. VIGLIANI E. C. Carbon disulphide poisoning in viscose rayon factories. Br J Ind Med. 1954 Oct;11(4):235–244. doi: 10.1136/oem.11.4.235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Valciukas J. A., Lilis R. Psychometric techniques in environmental research. Environ Res. 1980 Apr;21(2):275–297. doi: 10.1016/0013-9351(80)90029-8. [DOI] [PubMed] [Google Scholar]
  28. Vroom F. Q., Greer M. Mercury vapour intoxication. Brain. 1972;95(2):305–318. doi: 10.1093/brain/95.2.305. [DOI] [PubMed] [Google Scholar]
  29. Waldron H. A. Lead poisoning in the ancient world. Med Hist. 1973 Oct;17(4):391–399. doi: 10.1017/s0025727300019013. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The Yale Journal of Biology and Medicine are provided here courtesy of Yale Journal of Biology and Medicine

RESOURCES