Toxic neuropathy after glue sniffing: Clinical manifestations, electrophysiology, and sural nerve pathology

A 33-year-old man developed muscle weakness, muscle wasting and distal numbness as well as cognitive impairment and cerebellar dysfunction after long-term glue sniffing. The main ingredient of the glue vapor was toluene. Nerve conduction studies showed prolonged distal latencies, decreased amplitudes and slowing of nerve conduction velocities indicating an axonal polyneuropathy. Sural nerve pathology revealed axonal degeneration and reduction of fiber density, particularly of large myelinated fibers. After cessation of glue sniffing, the patient showed partial recovery as shown in clinical manifestations and electrophysiological study results. The data indicated that neuropathy caused by glue sniffing may partly recover after cessation of exposure.