Central and peripheral nervous system effects of metals: a survey

There are several categories of neurologic dysfunction which have been associated with metal intoxication. Many examples of case histories or animal studies where toxicity by metals has produced clinical manifestations and pathophysiologic changes similar to those found in certain primary neurological disorders have been reported. It is easy to make a diagnosis of metal intoxication in a subject whose work history and circumstances of exposure to specific substances is known. Observation of defined safety standards and time weighted averages for a work day in conjunction with environmental monitoring procedures are intended to reduce risk of undue absorption of known potential intoxicants. However, when a patient is seen by a physician and a probable neurological diagnosis is to be made in the absence of a detailed life-work history, the possible relationship to previous or current intoxication may be overlooked. This communication will review several neurological syndromes which have been found in association with metal accumulation.