Kronik toluen entoksikasyonuna bağlı korpus kallozum nekrozu: Psikiyatrik belirtilerle seyreden bir olgu sunumu

Nörotokslk bir madde olan tolueriin kötüye kullanımı nörolojik ve psikiyatrik komplikasyonla-ra neden olmaktadır. Ancak, bazı iş kollarında ça¬lışan ve uzun süre toluen etkisinde kalan kişilerde de benzer etkiler oluşabilmektedir. Görüntüleme çalışmalarında, kronik toluen entoksikasyonu so¬nucu beyin hacminde küçülme ve yaygın madde değişiklikleri meydana geldiği bulunmuştur. Be¬yinde oluşan yapısal değişikliklere bağlı olarak ilerleyici nörolojik ve psikiyatrik belirtilerin ortaya çıktığı gösterilmiştir. Bu yazıda, işyerinde sekiz yıl süreyle toluen etkisinde kalan, korpus kallozum nekrozu gelişen ve ilerleyici psikiyatrik belirtilerle seyreden bir olgu sunulmuştur.

Corpus callosum necrosis with psychiatric symptoms resulting from chronic toluene intoxication/exposure: A case presentation

Abuse of toluene, which is a neurotoxic su¬bstance, causes neurological and psychiatric complications. Similar complications may also be seen in people who are exposed to toluene long term in some industries. Decrease of brain volu¬me and generalised substance changes in brain have been found in imaging studies. Progressive neurological and psychiatric changes have been shown to be due to these changes. In this article, a subject was presented who was exposed to toluene at the workshop for 8 years and has suf¬fered corpus callosum necrosis with progressive psychiatric symptoms.

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  • 1- Xiong L, Matthes JD, Li J, ve ark. MR imaging of "spray heads": toluene abuse via 2- aerosol paint inhalation. AJNR Am J Neuroradiol, 1993; 14:1195-1199. 3- Muijser H, Geuskens RB, Hooisma J, ve ark. Behavioral effects of exposure to organic solvents in carpet layers. Neurotoxicol Teratol, 1996; 18:455-462. 4- Kamran S, Bakshi R. MRI in chronic toluene abuse: low signal in the cerebral cortex on T2-weighted images. Neuroradiology, 1998; 40:519-521. 5- Morrow LA, Kamis H, Hodgson MJ. Psychiatric symptomatology in persons with organic solvent exposure. J Consult Clin Psychol, 1993; 61:171-174. 6- Elofsson S, Gamberale F, Hindmarsh T et al. Exposure to organic solvents: a cross- sectional epidemiologic investigation on occupationally exposed car and industrial spray painters with special reference to the nervous system. Scan J Work Environ Health 1980; 6:239-273. 7- Lazar R, Su H, Melen O, Daghestani A. Multifocal central nervous system damage caused by toluene abuse. Neurology, 1983; 33:1337-1340. 8- Yazıcı MK, Demir B, Tanrıverdi N ve ark. Hamilton anksiyete değerlendirme ölçeği, değerlendiriciler arası güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi 1998; 9:114- 117. 9- Çorapcıoğlu A, Aydemir O, Yıldız M ve ark. DSM-IV için yapılandırılmış klinik görüşme formu. Hekimler Yayın Birliği 1999, Ankara. 10- Eisenberg DP. Neurotoxicity and mechanism of toluene abuse. Einstein Quart J Biol Med 2003; 19:150-159. 11 - Uchino A, Kato A, YuzurihaT, et al. Comparison between patient characteristics and cranial MR findings in chronic thinner intoxication. Eur Radiol 2002; 12:1338-1341. 12- Ukai H, Watanabe T, Nakatsuka H, et al. Dose-dependent increase in subjective symptoms among toluene exposed workers. Environ Res 1993; 60:274-289. 13- Tekgül H, Dizdarer G, Yalman O, ve ark. Associated brain abnormalities in patients with corpus callosum anomalies. Turk J Pediatr 1999; 41:173-180. 14- Taylor M, David AS. Agenesis of the corpus callosum: a United Kingdom series of 56 cases. J Neurol Neurosurg Psychiatry 1998; 64:131-134 15- Schaumburg HH. Toluene. Experimental and clinical neurotoxicology. New York: Oxford University Press, 2000: 1183-1189. 16- Gelenberg AJ, Lydiard RB, Rudolph RL et al. Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorder: A 6-month randomized controlled trial. JAMA, 2000 ; 21,283:3082-3088 17- Baker EL, Seppalainen AM. Session 3. Human aspects of solvent neurobehavioral effects. Report of the workshop session on clinical and epidemiologicaltopics. Neurotoxicology, 1986; 7:43-56. 18- Rickert CH, Karger B, Varchmin-Schultheiss K, et al. Neglect-associated fatal Marchiafava- Bignami disease in a non-alcoholic woman. IntJ Legal Med 2001 ;115:90-93.