Central Nervous System Toxicity

Central nervous system toxicity may result from either a direct toxic response to the systemic absorption of the hydrocarbon, as an indirect result of severe hypoxia secondary to aspiration, or as a result of simple asphyxiation. Systemic absorption usually occurs through the inhalation of highly volatile petroleum distillates, which may be absorbed inadvertently, for example as an occupational risk, or deliberately associated with solvent abuse.

Volatile solvent abuse most often occurs in teenagers and younger adults, especially from lower socioeconomic backgrounds and in particular cultures (e.g., Native Americans).10 These patients are described as "huffers" or "baggers" depending on whether they inhale through a rag soaked with the hydrocarbon held to the mouth or rebreathe into a plastic bag containing the hydrocarbon. The act of rebreathing to facilitate inhalation may also contribute to toxicity by producing significant hypercarbia and hypoxia. Many of the most commonly abused volatiles are listed in Tab.l.§ lZ4z4.

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