L'encéphalopathie toxique chronique provoquée par l'utilisation de solvants : dix ans d'expérience autour d'un diagnostic difficileL'encéphalopathie toxique chronique provoquée par l'utilisation de solvants : dix ans d'expérience autour d'un diagnostic difficile
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences. Pharmacy
Archives des maladies professionnelles et de l'environnement.. - Paris
70(2009):5, p. 494-501
University of Antwerp
Purpose of the study. In Belgium, chronic toxic encephalopathy (CTE) caused by all exposure to organic solvents is a recognized occupational disease since 1998. Patients with CTE present themselves with a series of vague symptoms and complaints, which Could be caused by a number of other internal, neurological or psychological disorders. In this article, We present a procedure for the diagnosis of CTE. Methods. Between 1998 and 2008, 203 cases suspected of having CTE have been referred to Our expert centre. The last five years, on average 30 to 40 new, cases were referred to our centre with signs of diminished attention, memory problem, tiredness, personality changes and depressive health complaints. Results and discussion. After a literature search and based on our experience, we recognize four keystones in the diagnostic procedure of CTE. First of all, the exposure to solvents has to be high and long. Consequently, medical anamnesis has to reveal narcotic and irritative signs in the patient from the beginning of the exposure, Which after several Years turn to be irreversible, after all initial period of fluctuation. Thirdly, the medical anamnesis and tests need to exclude other diseases and, finally, neuropsychological tests need to demonstrate objectively the complaints. Conclusion. Taking into account these phases, diagnosis seems to remain difficult and Uncertain in some cases. As exposure needs to be diminished or even more effectively to be stopped in patients with CTE to arrest further progress: on of the disease, this remedial action at the workplace is also required even Mien diagnosis is still uncertain, given the irreversible nature of the disease. (C) 2009 Elsevier Masson SAS. All rights reserved.