Trichlorethylene

Trichlorethylene (TCE) is used extensively in dry cleaning and for degreasing metal parts and extracting oils and fats from vegetable products. It is also used as an adhesive in the leather industry and occasionally in medicine as an anesthetic. A number of workers have become addicted to the fumes, since deliberate inhalation produces rapid euphoria. Fatalities resulting from bronchial constriction, pulmonary edema, and myocardial irritation have been reported.

TCE toxicity is associated with cranial and peripheral neuropathies. Mixed sensory and motor involvement of the trigeminal and facial nerves is characteristic of high-level TCE exposure. Neuro-ophthalmological findings include

retrobulbar neuropathy, optic atrophy, and oculomotor disturbances. Peripheral neuropathy is common, usually mixed and predominantly distal. Neuropathological examination has revealed extensive myelin and axonal degeneration. TCE may act as a demyelinating agent because of its lipid solvent qualities. The effects of TCE appear to be potentiated by alcohol.

Clinically, a history of possible TCE exposure should be investigated in any patient with trigeminal neuralgia or trigeminal dysfunction. Long-term exposure or acute high-level exposure also produces disturbances in memory. When a human volunteer was exposed to 2, 3, and 500 ppm for more than 2 hours, his major complaint was drowsiness.y At 500 ppm, however, a pronounced decrease in neuropsychological functioning was observed. General CNS symptoms include headaches, dizziness, fatigue, alcohol intolerance, neurasthenia, anxiety, and insomnia. Neurobehavioral effects include poor concentration and memory, decreased manual dexterity and visuospatial accuracy, and a slowed reaction time. As with the other organic solvents, treatment primarily involves removal from exposure.

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