Clinical, socio-demographic, neurophysiological and neuropsychiatric evaluation of children with volatile substance addiction.
BACKGROUND
Abuse of organic volatile substances in children has become a social health problem that is increasing in the recent years. Among these substances, toluene is highly preferred by abusers because of its euphoric effect, cheapness and easy availability. There is no published research on the clinical and neurophysiological evaluation of children with short-term volatile substance addiction.


METHODS
In this study, socio-demographic characteristics were questioned in 12 children with a mean age of 15 years and a duration of toluene abuse for a mean of 2.3 years, and the clinical characteristics of central and peripheral nervous system damage caused by volatile substances, particularly by toluene were analysed, and probable neurological disorders were investigated by means of neurophysiological and neuropsychological tests. All tests were compared with a control group.


RESULTS
Fifty-eight percent of the children included in the study had pathological findings in the neurological examination. There was pyramidal involvement in 25% and peripheral nerve involvement in 33.3% of the cases. Evaluation of the cognitive functions revealed 33.3% pathology in the 'Short Test of Mental Status' which assesses functions of orientation, attention, learning, arithmetic calculation, abstraction, information, construction and recall. Sensorial polyneuropathy was found in 33.3% of the cases in nerve conduction studies. Somatosensory-evoked potentials revealed pathology in 16.7% of the cases and brainstem-evoked potentials in 50% of the cases. No pathology was observed in electroencephalography and visual-evoked potentials.


CONCLUSIONS
In our study, neurophysiological and neuropsychiatric tests revealed that toluene causes slow progressive, clinical and subclinical central and peripheral nerve damage. In Turkey, because of cheapness, easy availability and legal use of volatile substances, the clinical extent of systemic and neurological toxicity of volatile substance abuse is increasing. Abuse of volatile substances, a currently increasing social issue, may create important physical problems which can be permanent.
Uzun
N
N
Istanbul University Cerrahpasa Medical School, Department of Neurology, Istanbul, Turkey. tadatepe@ttnet.net.tr
Kendirli
Y
Y
D000293:Adolescent; D002493:Central Nervous System Diseases / Q000139:chemically induced; D002540:Cerebral Cortex / Q000187:drug effects; D003072:Cognition Disorders / Q000139:chemically induced*; D004569:Electroencephalography / Q000379:methods; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005074:Evoked Potentials, Visual / Q000502:physiology; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination / Q000379:methods; D009483:Neuropsychological Tests; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects; D012997:Solvents / Q000633:toxicity*; D019966:Substance-Related Disorders / Q000150:complications* / Q000503:physiopathology; D014050:Toluene / Q000633:toxicity*
D012997:Solvents; D014050:Toluene