Neurology of endemic skeletal fluorosis.
Endemic skeletal fluorosis is widely prevalent in India and is a major public health problem. The first ever report of endemic skeletal fluorosis and neurological manifestation was from Prakasam district in Andhra Pradesh in the year 1937. Epidemiological and experimental studies in the endemic areas suggest the role of temperate climate, hard physical labor, nutritional status, presence of abnormal concentrations of trace elements like strontium, uranium, silica in water supplies, high fluoride levels in foods and presence of kidney disease in the development of skeletal fluorosis. Neurological complications of endemic skeletal fluorosis, namely radiculopathy, myelopathy or both are mechanical in nature and till date the evidence for direct neurotoxicity of fluoride is lacking. Prevention of the disease should be the aim, knowing the pathogenesis of fluorosis. Surgery has a limited role in alleviating the neurological disability and should be tailored to the individual based on the imaging findings.
Reddy
D Raja
DR
Department of Neurosurgery, Room No. 39, Apollo Hospital, Jubilee Hills, Hyderabad - 500 033, India. palvashareddy@gmail
D001847:Bone Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D001842:Bone and Bones / Q000473:pathology; D003937:Diagnosis, Differential; D019353:Endemic Diseases / Q000517:prevention & control; D005458:Fluoride Poisoning / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control / Q000601:surgery; D005459:Fluorides / Q000378:metabolism / Q000652:urine; D006801:Humans; D007194:India; D020258:Neurotoxicity Syndromes / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000517:prevention & control / Q000601:surgery; D009784:Occupational Diseases / Q000517:prevention & control; D011877:Radionuclide Imaging
D005459:Fluorides