Toxic Neuropathy
Toxins, poisons and chemicals can cause peripheral neuropathy. This can happen through drug or chemical abuse or through exposure to industrial chemicals in the workplace or in the environment (after either limited or long-term exposure). Common toxins that cause neuropathy include: exposure to lead, mercury, arsenic and thalium. Some organic insecticides and solvents can result in neuropathies. Sniffing glue or other toxic compounds can also cause peripheral neuropathy. Certain herbal medicines, especially Chinese herbal medicines, are particularly rich in mercury and arsenic and taking them can lead to peripheral neuropathy.
Toxins That Can Cause Peripheral Neuropathy
- Acrylamide
- Alcohol
- Arsenic
- Brevetoxin (from algae by means of the shellfish that eat it)
- Buckthorn berry toxin
- Cadmium
- Carbon disulfide (alone or as a contaminant of Agent Orange)
- Chlorofluorcarbon (new agent replacing 1-bromopropane)
- Ciguatera toxin (from algae by means of the shellfish that eat it)
- Dioxins (alone or as a contaminant of Agent Orange)
- Ethanol
- Ethylene glycol (antifreeze)
- Hexacarbons (in solvents and glues)
- Tetrodotoxin (from puffer fish)
- Lead
- Mercury (acute exposure to high dose)
- Nitrous oxide (causing depletion of vitamin B12)
- Organophosphates (insecticide)
- Saxitoxin (from algae by means of the shellfish that eat it)
- Thallium (associated with hair loss)
- Zinc Toxicity (leading to copper deficiency)
Because patients may have subtle pain or weakness, it may be difficult to arrive at a specific diagnosis of toxic neuropathy.
Note on Agent Orange: Over the years there has been suggestive evidence of an association between exposure to herbicides used in Vietnam and clinical neurological disorders, including peripheral neuropathy specifically. However, a review of research conducted over the last two decades (visit PubMed (US National Library of Medicine National Institutes of Health) indicates that the studies were limited by various factors, and thus all widely concluded that the evidence was insufficient to conclude or confirm a connection between exposure to Agent Orange and peripheral neuropathy.
Symptoms & Signs
(Not all symptoms and signs may be present.)
In feet:
- Pain
- Tingling
- Numbness
Other symptoms:
- Weakness
- Difficulty walking
- Many toxic components not only injure the peripheral nervous system but may also cause gastrointestinal symptoms, central nervous system involvement, optic neuropathy, muscle lesions or other systemic involvement (nausea, weight loss or skin changes).
Evaluation & Tests
(Not all evaluation and tests may be necessary.)
- Physical examination
- Neurological exam
- Electromyography
- Nerve conduction velocity test
- Blood test for toxins
- Urine test for toxins
Evolution & Prognosis
Toxic neuropathies are typically dose-dependent, and reversible after a certain time following cessation of exposure.
Treatment & Therapy
(Not all treatments and therapies may be indicated.)
- Over-the-counter pain medication for mild pain
- For severe pain, take over-the-counter pain medication or prescription drugs used for peripheral neuropathy, on a regular basis—rather than waiting until nighttime when symptoms can become more severe
- Eliminate exposure to toxins; both occupational and environmental
- Quit recreational drug habit
- Take safety measures to compensate for loss of sensation
- Ask your doctor about special therapeutic shoes (which may be covered by Medicare and other insurance).
Did You Know?
FPN's Biobank is Invaluable
The Foundation for Peripheral Neuropathy hosts the only biobank for peripheral neuropathy in the whole world!
The Peripheral Neuropathy Research Registry (PNRR) is a unique and invaluable resource to researchers and patients alike. This biobank is a set of patient data and samples intended for research use. With new research, there is always new opportunity for advancements in treatment and prevention strategies.