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‘Giant axonal neuropathy’ caused by industrial chemicals

Neurofilamentous axonal masses in man

From the Division of Neurology, Department of Medicine and the Laboratory of Neuropathology, Department of Pathology, University of Washington School of Medicine, Seattle, Washington.

Symmetrical polyneuropathy developed in two patients after they had been in contact with acrylamide and methyl n-butyl ketone, respectively. In sural nerve biopsy material from both patients, electron microscopy showed frequent focal axonal swellings containing masses of neurofilaments. Some axons undergoing axonal degeneration also were seen. These morphologic features are identical to those produced in experimental animals after exposure to these chemicals and are similar to those found in n-hexane neuropathy and in the three reported cases of giant axonal neuropathy. Sural nerve biopsy is an important diagnostic test in identifying cases of peripheral neuropathy caused by these chemicals.

Requests for reprints should be addressed to Dr. Sumi, Department of Medicine, Division of Neurology, University of Washington, Mail Stop RG-20, Seattle, Washington 98195.

Presented at the twenty-eighth annual meeting of the American Academy of Neurology, Toronto, Canada, April 1976.

This study was supported in part by USPHS Clinical Neurology Training Grant NS-05067-19.

Received for publication December 24, 1975.

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