Glue sniffer's neuropathy

Progressive sensorimotor neuropathy developed in 2 patients exposed to prolonged (chronic) inhalation of n hexane (glue sniffing). Sural nerve biopsies showed loss of axons; remaining axons were either normal or showed accumulation of filaments of 90 to 100 A thick, widened nodes of Ranvier, and focal enlargements. The muscle biopsy revealed neurogenic atrophy. Intramuscular nerve twigs and end plates, studied in one patient, showed loss of axons and nerve terminals. Unmyelinated axons also showed accumulation of 90 to 100 A thick filaments. The similarities between the pathologic findings in the peripheral nerve of these patients and those with acrylamide neuropathy suggest that the n hexane inhalation produces a dying back neuropathy.