Polyneuritis cranialis associated with industrial trichloroethylene poisoning.

Trichloroethylene came into wide use as a solvent and degreasing agent during the First World War, and in 1915 the first cases of cranial nerve damage in workers exposed to this substance were reported. Further reports followed and it was suggested that the toxic agent was a contaminant (Defalque, 1961; Browning, 1965). Jackson (1934) published an account ofthe anaesthetic properties of trichloroethylene, but the Council on Pharmacy and Chemistry of the American Medical Association (1936) criticized his use of this substance because of the earlier reported cranial nerve palsies and inhibited its use as an anaesthetic agent in the United States. Five years later Hewer and Hadfield (1941) introduced it into British anaesthetic practice and a number of cases of cranial nerve damage occurred. It soon became evident that in these cases the use of soda lime in closed circuit was the causative factor, as it led to decomposition of the drug (Firth and Stuckey, 1945). Avoidance of such conditions effectively prevented any further mishaps. The pathology of the cranial nerve lesions has not been previously described; the only necropsies available were two in the series of Humphrey and McClelland (1944).