Gulf War syndrome? Discussion of an unclear case

The Gulf War syndrome represents neurological and neuropsychological disord ers in veterans of the Persian Gulf war. Until today, the various symptoms observed could not be attributed to any defined disease. As a possible caus e, exposure to neurotoxic agents such as the organophosphates used during t he war has been suggested by many authors. We report on a 29-year-old man w ho suffered from dysmnesia, disturbance of orientation, cognitive impairmen t,and double vision. His history revealed several front-line operations in 1990 and 1991 during the Gulf War. Physical examinations showed a complex e ye-movement disturbance and a horizontal nystagmus, which was neuro-ophthal mologically confirmed. The early auditory potentials referred to a brainste m dysfunction and the cognitive disturbances correlated to changes in the l ate-appearing component of event-related potentials (P 300). Brain imaging with CCT, MRI, SPECT, PET, and EEG and CSF showed no pathologies. Neuropsyc hological tests disclosed severe cognitive impairment especially concerning memory. Three-month follow-up studies in a department of psychosomatic med icine excluded a dissociative disorder as a feature of a post-traumatic str ess or a conversion disorder. This is the first case of Gulf War syndrome i n Germany. We focus on an unfamiliar complication after the war. The recent literature is reviewed.