Reversible cerebral and brain stem dysfunction in n: Hexane neuropathy

• Main Authors: Vinod Puri, Abhijit Das Gupta, Neera Chaudhry, Ravindra Kumar Saran
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Annals of Indian Academy of Neurology
• Subjects: 6 th and 7 th nerve palsy; blink reflex; central nervous system involvement; down beat nystagmus; n- Hexane neuropathy
• Online Access: http://www.annalsofian.org/article.asp?issn=0972-2327;year=2015;volume=18;issue=4;spage=464;epage=467;aulast=Puri

A 18-year-old male, screen printer by profession developed sensory motor polyneuropathy, change in his behavior, bilateral 6 th and 7 th cranial nerve palsies, down beat nystagmus and cerebellar dysarthria. He had bilaterally prolonged P100 latency; left: 137 ms; right: 144 ms. P 37 was not recordable on either side while N 20 was normal. The inter latency difference between Ipsilateral R2 and Contralateral R2 was 6.15 ms, on the left side and normal on the right side. In the follow-up, there was normalization of the blink reflex study, improvement in P100 latency [left: 114 ms; right: 120 ms.] but worsening of peripheral nerve conductions. The sequential clinical recovery was of the behavioral dysfunction, down beat nystagmus, 6 th nerve, 7 th nerve involvement and ataxia, in that order. Sural nerve biopsy showed loss of large diameter myelinated fibers.