Toxic polyneuropathy due to n-hexane

Three women developed a predominantly motor polyneuropathy following industrial exposure to an adhesive agent containing 80.4% of n-hexane as a volatile substance. Histological and electron-microscopic studies were carried out on sural nerve and on soleus muscle. In the nerve, there were polymorphous changes in both myelin sheaths and axons of large diameter fibres. Irregular and swollen myelin sheaths and segmental swelling of axons with dissolution of neurotubules and evident increase of neurofilaments were frequently observed. Polymorphous inclusion bodies were often present in Schwann cell cytoplasm. The small myelinated and unmyelinated fibres did not show significant changes. The muscles showed denervation atrophy and focal degenerative myopathic changes, with presence of lymphocytic infiltrates and phagocytosis. This study confirms the noxious effect of n-hexane on the peripheral nerve, with development, in our cases, of a toxic polyneuropathy and denervation muscular atrophy with consistent myopathic changes.