Abstract

Toxic polyneuopathy due to glue sniffing is not commonly seen. Diagnosis can be complicated by the latent progression and a lack of disclosure of substance abuse by patients. Symptoms can be confused with the other more typical demyelinating neuropathies.

This case report describes a patient with a 15 year history of glue sniffing. The patient reported he had no ill-effects associated with his glue usage for 14 years. However after changing his regular ‘brand’ to an industrial type of glue he started to develop tingling in his legs. Three months later he was admitted to hospital following a fall and complaining of weakness and numbness in both legs. Clinically he presented with sensorimotor deficits affecting both the arms and legs, the latter being more severely affected. The symptoms were consistent with case reports of toxic polyneuropathy associated with n-hexane. Nerve conduction studies confirmed this showing delayed motor conduction, motor conduction block and absent F waves. Demonstrating a predominantly demyelinating neuropathy. After the patient stopped sniffing glue weakness progressed for a further 4 months. He has moved to a rehabilitation unit however his prognosis remains uncertain. Changes in the formulation of commercial glues and switching to industrial glues may result in more cases.