1/14. Psychogenic chemical sensitivity: psychogenic pseudoseizures elicited by provocation challenges with fragrances.A middle-aged woman with a 10-year history of disability attributed to chemical sensitivities complained that exposure to specific fragrances immediately elicited seizures. Video-EEG monitoring was performed in a hospital neurodiagnostic laboratory during provocative challenge studies employing fragrances identified by the patient as reliably inducing symptoms. The baseline clinical EEG was normal. Immediately after each provocation with air deodorant and perfume, she consistently showed both generalized tonic/clonic and multifocal myoclonic jerking, at times was nonresponsive, spoke with slurred speech, and complained of right-sided paralysis and lethargy. None of these events were associated with any EEG abnormalities. Psychological assessment (mmpi-2, MCMI-II) revealed personality traits that predisposed her to somatization and beliefs about environmental sensitivities. The convulsions were a manifestation of psychogenic pseudoseizures that had been iatrogenically reinforced.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
2/14. occipital lobe meningioma in a patient with multiple chemical sensitivities.BACKGROUND: The concurrent diagnosis of meningioma with increased intracranial pressure has not been reported previously in a patient who meets diagnostic criteria for multiple chemical sensitivities (MCS). methods: A patient who had been evaluated in an occupational medicine practice, and by several other physicians for sensitivity to chemical odors was found to have papilledema and a visual field deficit. The patient met the clinical criteria set forth by Cullen in 1987 for MCS. A magnetic resonance imaging (MRI) scan was performed. RESULTS: The MRI revealed a large occipital lobe meningioma, which was surgically resected. Removal of the meningioma had little effect on the patient's symptoms. She has been unable to return to her job as a custodian. DISCUSSION: The etiology of MCS has been disputed and is currently unresolved. Those who evaluate patients with MCS are reminded that meningiomas and other intracranial mass lesions can affect olfaction, and that patients with MCS can have treatable intracranial abnormalities.- - - - - - - - - - ranking = 0.25keywords = sensitivity (Clic here for more details about this article) |
3/14. A 37-year-old mechanic with multiple chemical sensitivities.A 37-year-old heating, ventilation, and air-conditioning mechanic developed respiratory, musculoskeletal, and central nervous system symptoms associated with a variety of odorous environmental chemicals. Organic disease was not evident, but the patient was distressed by these symptoms and was at risk for becoming disabled by them. His symptoms fit broadly into the condition recognized as multiple chemical sensitivity. multiple chemical sensitivity is a diagnostic term for a group of symptoms without demonstrated organic basis. The symptoms are characteristic of dysfunction in multiple organ systems, they increase and decrease according to exposure to low levels of chemical agents in the patient's environment, and they sometimes occur after a distinct environmental change or insult such as an industrial accident or remodeling. Although traditional medical organizations have not agreed on a definition for this syndrome, it is being increasingly recognized and makes up an increasing percentage of the caseload at occupational and environmental medicine clinics. Although there is often dispute about whether the symptoms have a functional or organic basis, an informed approach to evaluation, diagnosis, and management and a careful assessment of impairment, disability, and work relatedness are necessary. Careful exclusion of organic causes is critical, and this should be followed by a judicious approach to coping with symptoms.- - - - - - - - - - ranking = 0.5keywords = sensitivity (Clic here for more details about this article) |
4/14. multiple chemical sensitivity (MCS)--differential diagnosis in clinical neurotoxicology: a German perspective.The multiple chemical sensitivity syndrome (MCS) is a new cluster of environmental symptoms which have been described and commented on for more than 15 years now in the USA. In the meantime it has also been observed in European countries. The main features of this syndrome are: multiple symptoms in multiple organ systems, precipitated by a variety of chemical substances with relapses and exacerbation under certain conditions when exposed to very low levels which do not affect the population at large. There are no lab markers or specific investigative findings. In our view, MCS is not a separate clinical syndrome but a collective term. A very small part of the patients in question may actually exhibit a somatic or psychosomatic response to low levels of a variety of chemicals in the environment. For another part, even if the MCS symptoms are induced by chemical substances in the environment, the basic hypersensitivity is a psychological stress reaction. In the third and largest group, the patients have been misdiagnosed, i.e. a somatic or psychiatric disease has been overlooked. There is a fourth group of patients in whom there is no evidence of any exposure at all but instead a belief system installed by certain physicians, the media and other groups in society. This paper tries to describe the neurological and neurotoxic aspects of MCS problems and to illustrate it with examples of an alleged outbreak of chronic neurotoxic disease caused by pyrethroids in germany. research strategy should establish clearly determined diagnostic criteria, agreement on the use of specific questionnaires as well as clinical and technical diagnostic procedures, prospective clinical studies of MCS patients and comparative groups as well as experimental approaches.- - - - - - - - - - ranking = 1.5keywords = sensitivity (Clic here for more details about this article) |
5/14. Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure.multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms occur with low-level chemical exposure; whether it is an organic disease initiated by environmental exposure or a psychological disorder is still controversial. We report a 38-year-old male worker with chronic toluene exposure who developed symptoms such as palpitation, insomnia, dizziness with headache, memory impairment, euphoria while working, and depression during the weekend. Upon cessation of exposure, follow-up neurobehavioural tests, including the cognitive ability screening instrument and the mini-mental state examination, gradually improved and eventually became normal. Although no further toluene exposure was noted, non-specific symptoms reappeared whenever the subject smelled automotive exhaust fumes or paint, or visited a petrol station, followed by anxiety with sleep disturbance. During hospitalization for a toluene provocation test, there was no difference between pre-challenge and post-challenge PaCO(2), PaO(2), SaO(2) or pulmonary function tests, except some elevation of pulse rate. The clinical manifestations suggested that MCS was more relevant to psychophysiological than pathophysiological factors.- - - - - - - - - - ranking = 1.25keywords = sensitivity (Clic here for more details about this article) |
6/14. Multiple-chemical sensitivity.Multiple-chemical sensitivity (MCS) is a condition in which individuals have an acute hypersensitivity to low levels of chemicals found in everyday substances, such as household cleaning agents, pesticides, fresh paint, new carpeting, synthetic building materials, newsprint, perfume, and numerous other petrochemical products. This condition continues to remain somewhat of a mystery to the medical community, and its true prevalence rate is unknown because many cases are not identified and reported as MCS. This article will inform the reader about the condition of MCS.- - - - - - - - - - ranking = 1.5keywords = sensitivity (Clic here for more details about this article) |
7/14. Patient statement: chemically sensitive.There are three areas of my experience with chemical sensitivity that may interest you. The first is the onset of this condition and what happened to me over time as I became chemically sensitive in my work place. The second is my experience with the "medical community." The third is the effect chemical sensitivity has had on my career.- - - - - - - - - - ranking = 0.5keywords = sensitivity (Clic here for more details about this article) |
8/14. Patient statement: chemical sensitivity--one victim's perspective.Not a day goes by that I don't miss my old life and the old me. To illustrate how my life has changed, I have two brief stories. In 1982, I developed a lending procedure in conjunction with Banker's life insurance Company that enabled commercial real estate developers to secure permanent financing for property that had not yet been developed--in essence using a permanent loan in place of a construction loan. It fixed the interest rate, at a time when new construction rates were bankrupting many projects and it allowed the developer to invest the excess funds to offset interest expenses. I received national recognition for this loan. In 1989, the police found me wandering around in 15 inches of snow, in below zero weather with no shoes or coat. The officer took me to the hospital because I was obviously disoriented. I didn't even know my name or where I lived. These stories show the disparity between my life as a successful, independent business woman and my life as someone who is chemically disabled.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
9/14. Neurasthenic fatigue, chemical sensitivity and GABAa receptor toxins.Following observation of fatigue syndromes in people who have been occupationally exposed to pesticides and insecticides which exert their toxicity through the GABAa receptor, we have formulated the hypothesis that fatigue syndromes in general may be secondary to altered sensitivity of the GABAa receptor. We discuss the possible involvement of organochlorine compounds which are widespread in the environment. Organophosphate compounds may have similar toxic effects through damaged cholinergic input to the dentate gyrus of the hippocampus where cholinergic and GABAergic transmission are closely linked.- - - - - - - - - - ranking = 1.25keywords = sensitivity (Clic here for more details about this article) |
10/14. Behavioral treatment of phobic avoidance in multiple chemical sensitivity.The clinical ecology model of environmental illness, or multiple chemical sensitivity (MCS), and particularly the theoretical assumptions, diagnostic procedures, and therapeutic recommendations promulgated by clinical ecologists are reviewed. No scientific evidence is found for their claims. MCS is conceptualized, instead, as a phobic disorder explicable in terms of the two-factor model of avoidance. Three cases of MCS are discussed in light of this model, and a comprehensive behavioral treatment package that includes biofeedback-assisted in vivo desensitization and cognitive restructuring is proposed.- - - - - - - - - - ranking = 1.25keywords = sensitivity (Clic here for more details about this article) |
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