KASMEJ
Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

eISSN: 2757-9336
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
N-hexane neuropathy: more frequent than expected
Abstract
Organic solvents that are widely used in industrial production and abused amongst teenagers for recreational purposes may cause some neurological abnormalities including polyneuropathy. Poorly ventilated working environments and working without protective garments are the most common reasons of intoxication. N-hexane toxicity often causes sensorimotor mixed type demyelinating neuropathy, but axonal degeneration is not rare. We report five cases that had mainly axonal motor polyneuropathy due to n-hexane containing glue usage, with clinical and electrophysiological data. Clinical and electrophysiological examinations revealed predominantly motor findings. One patient had delayed P100 potential, two had abnormal conduction in fasciculus gracilis. “Coasting” phenomenon was observed in one patient. Neuropathy due to toxic agents is an important public health problem. Working place conditions must be strictly controlled if toxic materials are present. Patients who had electromyography compatible with polyneuropathy should be questioned for toxic exposure. Asymptomatic workers should also be examined. Patients should be followed for the possibility of “coasting” effect.

Keywords : N-hexane, polyneuropathy, electrophysiology, organic solvents

Download Article


1. Abbritti G, Siracusa A, Cianchetti C, et al. Shoe-makers’ polyneuropathy in Italy: the aetiological problem. Br J Ind Med. 1976;33(2):92-99. doi:10. 1136/oem.33.2.92
2. Alpaydin Baslo S, Ozturk O, Dayan C, Atakli D, Baslo MB. Another brick in the wall: is hexane neuropathy a ‘nodo-paranodopathy’? Acta Neurol Belg. 2021;121(2):373-378. doi:10.1007/s13760-020-01372-3
3. Anthony DC, Boekelheide K, Anderson CW, Graham DG. The effect of 3,4-dimethyl substitution on the neurotoxicity of 2,5-hexanedione. II. dimethyl substitution accelerates pyrrole formation and protein crosslinking. Toxicol Appl Pharmacol. 1983;71(3):372-382. doi:10.1016/0041-008X(83)90263-9
4. Bates MN, Pope K, So YT, Liu S, Eisen EA, Hammond SK. Hexane exposure and persistent peripheral neuropathy in automotive technicians. Neurotoxicology. 2019;75:24-29. doi:10.1016/j.neuro.2019.08.008
5. Cardona A, Marhuenda D, Martí J, Brugnone F, Roel J, Perbellini L. Biological monitoring of occupational exposure to N-hexane by measurement of urinary 2,5-hexanedione. Int Arch Occup Environ Health. 1993;65(1):71-74. doi:10.1007/BF00405891
6. Chang AP, England JD, Garcia CA, Sumner AJ. Focal conduction block in N-hexane polyneuropathy. Muscle Nerve. 1998;21(7):964-969. doi:10.1002/(SICI)1097-4598(199807)21:7<964::AID-MUS10>3.0.CO;2-9
7. Chang CM, Yu CW, Fong KY, et al. N-hexane neuropathy in offset printers. J Neurol Neurosurg Psychiatry. 1993;56(5):538-542. doi:10.1136/jnnp.56.5.538
8. Chang YC. Neurotoxic effects of n-hexane on human central nervous system: evoked abnormalities in N-hexane polyneuropathy. J Neurol Neurosurg Psychiatry. 1987;50(3):269-274. doi:10.1136/jnnp.50.3.269
9. Chaqda M, El Mellakh M, Kissani N, Louhab N. Neuropathy caused by addictive inhalation of N-hexane in glue sniffers. Presse Med. 2019;48(5):568-572. doi:10.1016/j.lpm.2019.02.004
10. 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;39(12):1151-1161. doi:10.1136/jnnp.39.12.1151
11. Graham DG, Anthony DC, Szakál-Quin G, Gottfried MR, Boekelheide K. Covalent crosslinking of neurofilaments in the pathogenesis of N-hexane neuropathy. Neurotoxicology. 1985;6(4):55-63. doi:10.1016/0161-813X(85)90006-1
12. Graham DG, Szakál-Quin G, Priest JW, Anthony DC. In vitro evidence that covalent crosslinking of neurofilaments occurs in gamma-diketone neuropathy. Proc Natl Acad Sci USA. 1984;81(15):4979-4982. doi:10.1073/pnas.81.15.4979
13. Huang CC. Polyneuropathy induced by N-hexane intoxication in Taiwan. Acta Neurol Taiwan. 2008;17(1):3-10.
14. Issever H, Malat G, Sabuncu HH, Yuksel N. Impairment of colour vision in patients with N-hexane exposure-dependent toxic polyneuropathy. Occup Med (Lond). 2002;52(4):183-186. doi:10.1093/occmed/52.4.183
15. Kutlu G, Gomceli YB, Sonmez T, Inan LE. Peripheral neuropathy and visual evoked potential changes in workers exposed to N-hexane. J Clin Neurosci. 2009;16(10):1296-1299. doi:10.1016/j.jocn.2008.11.019
16. LoPachin RM, Gavin T. Toxic neuropathies: Mechanistic insights based on a chemical perspective. Neurosci Lett. 2015;596:78-83. doi:10.1016/j.neulet.2015.03.024
17. Misirli H, Domaç FM, Somay G, Araal O, Ozer B, Adigüzel T. N-hexane induced polyneuropathy: a clinical and electrophysiological follow up. Electromyogr Clin Neurophysiol. 2008;48(2):103-108. doi:10.1016/j.emg. 2008.01.001
18. Pastore C, Izura V, Marhuenda D, Prieto MJ, Roel J, Cardona A. Partial conduction blocks in N-hexane neuropathy. Muscle Nerve. 2002;26(1): 132-135. doi:10.1002/mus.10170
19. Saito I, Shibata E, Huang J, Hisanaga N, Ono Y, Takeuchi Y. Determination of urinary 2,5-hexanedione concentration by an improved analytical method as an index of exposure to N-hexane. Br J Ind Med. 1991;48(8):568-574. doi:10.1136/oem.48.8.568
20. Schaumburg HH, Spencer PS. Degeneration in central and peripheral nervous systems produced by pure N-hexane: an experimental study. Brain. 1976;99(2):183-192. doi:10.1093/brain/99.2.183
21. Smith AG, Albers JW. n-Hexane neuropathy due to rubber cement sniffing. Muscle Nerve. 1997;20(11):1445-1450. doi:10.1002/(sici)1097-4598(199711)20::11<1445:AID-MUS3>3.0.co;2-3
22. Takeuchi Y. N-hexane polyneuropathy in Japan: a review of n-hexane poisoning and its preventive measures. Environ Res. 1993;62(1):76-80. doi:10.1006/enrs.1993.1024
23. Uzun N, Savrun FK, Kızıltan ME. Peripheral nerve system damage in chronic toluene and n-hexane intoxication: electrophysiological investigation. Cerrahpaşa Tıp Dergisi. 2001;32(3):142-150.
24. Yuksel G, Karlıkaya G, Tutkavul K, et al. Clinical and electrodiagnostic findings of N-hexane neuropathy. J Neurol Sci Turk. 2007;24(3):219-225. </ol> <p>
Article available in :
Volume 5, Issue 2, 2025
Page : 137-142
https://doi.org/10.51271/KMJ-0198
Article Information
Received : 01 Ağu 2024
Accepted : 18 Kas 2024
Published : 20 Haz 2025
Corresponding Author :

Tuğçe Mengi: Department of Neurology, Buca Seyfi Demirsoy Training and Research Hospital, Demokrasi University, İzmir, Turkiye

[email protected]
Citation : Seçil Y, Tokuçoğlu F, Mengi T, Doğan GN, Kurt İncesu T, Beckmann Y. N-hexane neuropathy: more frequent than expected. Kastamonu Med J. 2025;5(2):137-142.

Read: 22
Cited: 0
Download : 81
_Footer