Inhalant-Related Psychiatric Disorders Workup

Updated: Feb 19, 2019
  • Author: Guy E Brannon, MD; Chief Editor: Ana Hategan, MD, FRCPC  more...
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Workup

Laboratory Studies

See the list below:

  • Sequential multiple analysis

    • Electrolyte (eg, sodium, potassium, chloride) levels

    • Liver function tests

    • BUN determination

    • Creatinine level

    • Cholesterol level

    • Anion gap measurement (see the Anion Gap calculator)

  • Complete blood cell count with differential and platelets

  • Urinalysis, with routine screenings for hippuric acid

  • Urine drug screen

  • Rapid plasma reagin testing

  • Thyrotropin testing

  • Thyroid function tests

  • Urine pregnancy tests

  • Creatine kinase, if not included in sequential multiple analysis

  • Twenty-four–hour urine test

  • Heavy metal screening test

  • HIV-antigen test

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Imaging Studies

See the list below:

  • Order a CT scan and EEG if neurological symptoms are present (eg, hearing loss, headaches, cerebellar signs, paresis, motor impairment, parkinsonism, encephalopathy).

  • Perform an EEG to help identify seizure activity, specifically temporal lobe epilepsy.

  • If a positron emission tomography scan cannot be obtained, order a single-photon emission computed tomography scan to help identify nonhomogenous uptake of radiopharmaceuticals, which may indicate hypoperfusion and hyperperfusion foci.

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Other Tests

See the list below:

  • Electrocardiogram (may be necessary)

  • Wechsler Adult Intelligence Scale

  • Wide Range Achievement Test

  • Trail-Making Test

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Procedures

See the list below:

  • Liver or kidney biopsy, if indicated

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Histologic Findings

Findings may include evidence of heavy metal damage to specific organs, such as that caused by lead in gasoline and paint, and inflammation, rhabdomyolysis, brain atrophy, and renal tubular acidosis.

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