CHRONIC CARBON-DISULFIDE ENCEPHALOPATHY

To understand central nervous damage after long-term exposure to carbo n disulfide(CS2), 10 patients who had polyneuropathy with various neur opsychiatric symptoms in a viscose rayon plant were studied. Clinical and laboratory examinations including electroencephalography (EEG), br ain computed tomography (CT), brain magnetic resonance images (MRI), a nd carotid duplex sonography were carried out. Clinically, headache, u npleasant dreams, memory impairment, fatigue, anorexia and emotional l ability were common in these patients while 2 patients had stroke epis odes. EEGs were all normal. Brain CT scan showed mild cortical atrophy in 3 and low density lesions in the basal ganglia in 3. Brain MRI stu dies also disclosed mild cortical atrophy in 4 and multiple lesions in volving the basal ganglia and corona radiata in 4. Carotid duplex sono graphy revealed mild atherosclerosis with plaques (20% stenosis) of ex tracranial vessels in 6. However there was no significant difference i n flow velocities and flow volumes in the extracranial carotid arterie s between patients and the normal controls. Interestingly, 2 patients had multiple brain lesions in the subcortical white matter but without strokes. In conclusion, encephalopathy with possible strokes may occu r after chronic exposure to CS2, as well as polyneuropathy. The lesion s usually involve the basal ganglia and subcortical white matter. Furt hermore, MRI study may detect brain lesions particularly in the subcor tical white matter areas before the occurrence of stroke.