In the editorial "Neuropsychological Assessment of Toxic Encephalopathy " [1987] it was proposed that the patient's history of emotional trauma should be considered in the pathogenesis of "solvent syndrome." There is, however, a report in a psychiatric journal that perhaps is not well known by the industrial/occupational medical profession [Lindberg et al., 19821. Thirteen patients who suffered from severe neurasthenic syndromes, purportedly caused by exposure to solvents, were examined and treated using a psychotherapeutic method adapted to psychosomatic diseases. The results indicated unequivocally that in all patients the symptoms had a psychological causation and that they could be successfully treated!
In a recent WHO report [Cavanagh, 19851, it was concluded that the damage to experimental animals of long-lasting exposure to solvents is not analogous to, and cannot explain, the neurasthenic syndrome seen after occupational exposure to sol- vents. Experimental damages were seen mostly in the cerebellum and are in good agreement with reports of dysarthria and a cerebellar type of ataxia seen after heavy sniffing of toluene. In addition, a good analogy between experimental and clinical findings after heavy exposure to alcohol, which primarily damages the cerebral cortex was noted.
The most important factor in understanding the pathogenesis of neurasthenic syndromes after exposure to solvents is still a thorough clinical examination of the patient. Here an appropriate psychotherapeutic examination and treatment are an important factors that are also necessary to achieve optimal rehabilitation.