title: Chronic solvent-induced encephalopathy: European consensus of neuropsychological characteristics, assessment, and guidelines for diagnostics.
abstract: BACKGROUND
  The presence of neuropsychological impairment is a hallmark of chronic solvent-induced encephalopathy (CSE), and using clinical neuropsychological procedures to generate a valid assessment of the condition is crucial for its diagnosis. The goals of this consensus document are to provide updated knowledge of the neuropsychological characteristics of CSE and to provide internationally acceptable guidelines for using neuropsychological assessments in the process of diagnosing patients who are suspected of having CSE.
  
  
  METHODS
  A European working group that was composed of experts in the field of the clinical diagnosis of CSE met at several round-table meetings and prepared this report. The first section of the consensus paper addresses a review of the relevant literature that was published between 1985 and March 2012. The second section addresses recommendations for the clinical neuropsychological assessment of patients who are suspected of having CSE.
  
  
  RESULTS
  The literature review indicates that the most common neuropsychological impairments in CSE patients are within the domains of attention, particularly the speed of information processing, memory, and motor performance. It appears that the influence of CSE on memory processes mainly involves immediate recall and generally involves verbal, visual and visuospatial material. In the second section, six recommendations are presented regarding important functional domains for the neuropsychological diagnostic process of CSE that relate to the evaluation of neuropsychological impairment, the assessment and evaluation of symptoms, differential diagnostic considerations, the reliability and validity of neuropsychological test results, and the retesting of patients.
  
  
  CONCLUSIONS
  These recommendations will contribute to the improvement of the process for accurately diagnosing CSE, better counselling for CSE patients, the comparability of epidemiological data between countries, and finally, by raising awareness, these recommendations will contribute to combating the adverse health effects of occupational exposure to solvents.
authors.affiliation: Netherlands Center for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands. e.vanvalen@amc.uva.nl
authors.forename: Evelien
authors.initials: E
authors.lastname: van Valen
authors.forename: Christoph
authors.initials: C
authors.lastname: van Thriel
authors.forename: Ritva
authors.initials: R
authors.lastname: Akila
authors.forename: Linda Nordling
authors.initials: LN
authors.lastname: Nilson
authors.forename: Rita
authors.initials: R
authors.lastname: Bast-Pettersen
authors.forename: Markku
authors.initials: M
authors.lastname: Sainio
authors.forename: Frank
authors.initials: F
authors.lastname: van Dijk
authors.forename: Gert
authors.initials: G
authors.lastname: van der Laan
authors.forename: Maarten
authors.initials: M
authors.lastname: Verberk
authors.forename: Ellie
authors.initials: E
authors.lastname: Wekking
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001288:Attention / Q000187:drug effects; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D002908:Chronic Disease; D003071:Cognition / Q000187:drug effects; D032921:Consensus; D006801:Humans; D011939:Mental Recall / Q000187:drug effects; D009043:Motor Activity / Q000187:drug effects; D009483:Neuropsychological Tests / Q000592:standards*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health / Q000592:standards; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012997:Solvents / Q000009:adverse effects*; D013997:Time Factors; D014796:Visual Perception / Q000187:drug effects
chemical_list: D000395:Air Pollutants, Occupational; D012997:Solvents