Principles and practice of occupational neurology: an overview

Diseases of both central and peripheral nervous systems may be the consequence of chemical and physical exposures occurring in the workplace. The resulting syndromes depend upon the type of hazard, of exposure (acute vs chronic), and of neuronal organization that is affected. Diagnosis of occupational neurologic diseases may prove to be difficult because they rarely display pathognomonic signs and almost always a quantitative assessment of exposure is missing. Therefore medical and occupational histories are of paramount importance and often represent the only source of information to establish causality. Prevention of occupational neurologic disorders requires industrial hygiene programs, ergonomic interventions, and the monitoring of workers. Neuroepidemiology may detect unrecognized and subtle subclinical effects of exposure, including behavioral disorders, and it may also represent the appropriate tool to investigate outbreaks of neurologic diseases in a community. However, in some circumstances the results of neuroepidemiologic studies are controversial because of defects in study design.