Organic Solvent Neurotoxicity Treatment & Management

Updated: Dec 11, 2018
  • Author: Jonathan S Rutchik, MD, MPH, FACOEM; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
  • Print

Medical Care

For acute or emergency scenarios, symptomatic treatment is usually the mainstay of medical care. After emergency issues are addressed, reducing the intensity or eliminating exposure is the appropriate goal.

  • Reducing inhalation, ingestion, or dermatologic exposures may be accomplished by not eating or smoking in the workplace and by improving use of PPE, including masks and breathing apparatuses. Other protective measures are wearing gloves made of latex, Vicryl, or other impermeable material to limit skin absorption and by showering and changing clothes on completion of job tasks.

  • Changing the duration of exposure is also important. This may be accomplished by changing shifts and rotating jobs in a department.

  • Engineering controls, such as improving ventilation or shifting chemical processes to less-toxic substitutes, are other actions that the clinician might suggest.

  • Removal from exposure may follow a reduction of exposure if symptoms are severe, life threatening, or persistent. Reduction and/or removal are important diagnostic and treatment options. If symptoms abate after these steps, they better support the diagnosis of sequelae secondary to exposure than if they persist.

  • Clinicians should be willing to follow up their patients and to determine if their symptoms are improving compared with their relative exposure. A clinician must be willing to consider recommending a job change (eg, modified or restricted duty) to the employer. At that point, referral to appropriate specialists may be indicated.

  • Antidepressant medication, including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, have been helpful for managing the alterations of mood that may be part of the syndrome, as well as for reducing pain in patients with symptoms of peripheral neuropathy.

  • Psychological counseling, brain rehabilitation, and physical and occupational therapy may be appropriate.



The patient may be referred to an internist, occupational medicine specialist, ophthalmologist, neuropsychologist, neuromuscular or behavioral neurologist, or other specialists depending on the specifics of the case.