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Routine diagnostic procedures for chronic encephalopathy induced by solvents: survey of experts
J A van der Hoek1, M M Verberk, G van der Laan
1Netherlands Center of Occupational Diseases, Coronel Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. KCJvanderHoek@compuserve.com
Objectives:
To study the routine diagnostic procedures used in different countries for chronic toxic encephalopathy (CTE) induced by solvents.
Methods:
By means of a postal questionnaire selected international experts were asked about the methods they use to diagnose patients suspected of having CTE induced by solvents, the number of patients, entrance criteria, and the results of these diagnostic procedures.
Results:
18 Experts working in 18 diagnostic centres responded. Most of them agreed that a diagnostic procedure for CTE induced by solvents should contain an interview and neurological, physical, and neuropsychological examinations. However, the tests used were very different, as were the classifications for CTE. Depending on the institute, a diagnosis of CTE was made in 6%--70% of the referred patients. The proportion of patients with CTE stage I ranged from 0% to 33%, stage II from 5% to 100%, and stage III from 0% to 95%.
Conclusion:
The intentions of the two 1985 conferences that aimed at clarity and uniformity of diagnosis of CTE induced by solvents are far from reached. It is possible, now the conditions are more favourable, to aim at this important goal and recommend some refinement of the then proposed criteria.