Hypokalemic Periodic Paralysis in Chronic Toluene Exposure

• Published in: Archives of neurology (Chicago) Vol. 37; no. 10; p. 673
• Main Authors: Bennett, Richard H, Forman, Harvey R
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 01.10.1980
• Subjects: Acidosis, Renal Tubular - chemically induced; Acidosis, Renal Tubular - complications; Adult; Chlorides - blood; Humans; Hypokalemia - chemically induced; Hypokalemia - complications; Hypokalemia - etiology; Male; Paralysis - chemically induced; Paralysis - etiology; Periodicity; Toluene - poisoning
• DOI: 10.1001/archneur.1980.00500590097021
• ISSN: 0003-9942

Toluene is an organic solvent used in paint sprays, lacquer thinners, and household glues. Because the vapor is intoxicating when inhaled, toluene abuse has become prominent.1 Neurologic complications of exposure to toluene and other inhalable organic solvents, such as n-hexane, methylbutyl ketone, and acrylamide, include a variety of central and peripheral temporary and permanent effects.1-5 We report a less well-recognized complication of chronic toluene exposure, hypokalemic periodic paralysis secondary to renal tubular acidosis. REPORT OF A CASE A 22-year-old man was admitted to the hospital in July 1979 with the sudden onset of abdominal pain, nausea, and vomiting. Aside from a mild fever, the results of general examination were unremarkable. There was, however, mild generalized weakness with diminished reflexes. Laboratory studies (Table) showed a severe hypokalemic hyperchloremic metabolic acidosis. Complete blood cell count, tests of liver function, and roentgenogram of the chest were normal. Other laboratory studies