Sensitive technique for detecting subclinical lead neuropathy

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Seppäläinen, A. M., and Hernberg, S. (1972).Brit. J. industr. Med.,29, 443-449. Sensitive technique for detecting subclinical lead neuropathy. Subclinical neuropathy was studied in 39 male lead workers. Although 31 had a diagnosis of poisoning, all were without clinical signs of neurological impairment. A standard electromyogram revealed abnormalities (fibrillations and/or diminished number of motor units) in 24 men. The mean maximum conduction velocities (MCV) of the ulnar and median nerve were significantly lower in the group of lead workers as compared with an age-matched control group. Measurement of the conduction velocity of the slower fibres (CVSF) of the ulnar nerve proved to be a very sensitive indicator of lead damage. This measurement was done as a modification of Hopf's technique using a partial antidromic block. A combination of this variable and the distal latency of the median nerve discriminated lead workers from controls better than any other combinations. The findings are consistent with slight neuropathy. They further show that lead also affects certain portions of the fibres in the proximal part of the nerve.

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