Polyvinyl chloride and plasticizer intoxication have a degenerative effect on the cerebral white matter characterized by bilateral, confluent lesions that reflect diffuse demyelination. We report similar clinical and neuroimaging manifestations in two patients with inhalation of these substances. MRI findings described here may be helpful in the diagnosis of future cases of suspected chloroparaffin poisoning.
StedwellREAllenKMBinderLS: Hypokalemic paralysis: A review of the etiologies, pathophysiologies, presentation and therapy. Am J Emerg Med10: 143–8, 1992.
ShintaniMYamashitaMNakanoA: Central pontine and extrapontine myelinolysis associated with type 2 diabetic patient with hypokalemia. Diabetes Res Clin Pract68: 75–80, 2005.
8.
KeswaniSC: Central pontine myelinolysis associated with hypokalaemia in anorexia nervosa. J Neurol Neurosurg Psychiatry75: 663, 2004.
9.
KimJHChangKHSongIC: Delayed encephalopathy of acute carbon monoxide intoxication: Diffusivity of cerebral white matter lesions. Am J Neuroradiol24: 1592–7, 2003.
10.
SharpCWFilleyCMHallidayW: The effects of toluene in the central nervous system. J Neuropath and Eperiment Neurol63: 1–12, 2004.
11.
TruemperEde la RochaReyes SAtkinsonS: Clinical characteristics, pathophysiology, and management of hydrocarbon ingestion: A case report and review of the literature. Pediatr Emerg Care3: 187–193, 1987.
12.
YamanouchiNaotoOkadaShin-IchiKodamaKazuhiro: White Matter Changes Caused by Chronic Solvent Abuse: Am J Neuroradiol16: 1643–1649, 1995.
13.
KubilayASerraSTurkayD: Cranial MR Findings in Chronic Toluene Abuse by Inhalation. Am J Neuroradiol23: 1173–1179, 2002.
14.
OieLHersougLGMadsenJO: Residential exposure to plasticizers and its possible role in the pathogenesis of asthma. Environ Health Perspect105: 972–978, 1997.
15.
OhlsonCGHardellL: Testicular cancer and occupational exposures with a focus on xenoestrogens in polyvinyl chloride plastics. Chemosphere40: 1277–1282, 2000.
16.
NielsonJAkessonBSkerfvingS: Phthalate tester exposure-air levels and health of workers processing polyvinyl chloride. Ind Hyg Assoc J46: 643–647, 1985.
17.
WyattICouttsCTElcombeCR: The effect of chlorinated paraffins on hepatic enzymes and thyroid hormones. Toxicology29: 81–90, 1993.
18.
HsiaoTJWangJDYangPM: Liver fibrosis in asymptomatic polyvinyl chloride workers. J Occup Environ Med46: 962–66, 2004.
