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Recognizing neurotoxicity: the symptoms of brain injury from exposure to hazards like lead paint and toxic chemicals vary widely. But there are ways you and your experts can pinpoint the damage and its cause.

Article Excerpt
Neurotoxicity--poisoning of the brain and nervous system--is a well-documented effect of exposure to many widely used chemicals, yet doctors (and lawyers) often fail to recognize it. Chemically injured clients often report a confusing array of symptoms, with no medical diagnosis. The symptoms may seem vague and unconnected, leading you to wonder, "Could these symptoms really be caused by a chemical exposure?" Once you recognize the signs and understand them in context--as a constellation of symptoms resulting from a toxic injury--you will have greater confidence in bringing your client's case to justice.

A person who has suffered a serious chemical injury is likely to have sustained considerable damage to his or her brain and nervous system. This is important for a lawyer to know, because doctors often recognize only the person's physical illness, not realizing that serious brain and nervous system damage may have also occurred.

Neurotoxicity can be documented, but perhaps not in the way you might think. A person's ability to think, perceive, control emotions, plan, and manage his or her life can diminish drastically without anything being visible to a radiologist or neurologist on an MRI or a CT scan. (1)

The most reliable and widely accepted way to assess actual brain function is through neuropsychological evaluation. (This is true for head-injury patients and those suffering from dementia, as well as those affected by exposure to toxic chemicals.)

Researchers have noted that imaging techniques are often of little value in evaluating neurotoxicity. (2) In our and others' experience, imaging techniques can occasionally pick up abnormalities caused by neurotoxicity and may be helpful for forensic purposes, but they are not cost-beneficial for routine screening. (3)

Neuropsychological testing tends to be more sensitive to brain injury than CT and routine MRI scans, which provide only a static and relatively gross view of neural structure. In one study of six head-injury cases, CT and/or MRI scans yielded little or no evidence of neuropathology as detected by neuropsychological testing.

Positron emission tomography (PET) scans, however, corroborated the impaired function. (4) PET and SPECT (single photon emission computed tomography) scans offer a more dynamic look at brain structure, but both of these tests still need interpretation as to the cause of the abnormality (which could be benign).

Common symptoms

What do chronic pain, anxiety, neurological problems, confusion, psychiatric symptoms, and cognitive declines have in common? They can all result from neurotoxic chemical exposure.

Symptoms of neurotoxicity include memory and concentration problems; confusion; multiple sclerosis or MS-type symptoms; impaired control of the limbs, bladder, or bowels; headaches or migraines; sleep disorders, including sleep apnea; eye problems that are neurological in origin; balance and hearing problems; muscle weakness; anxiety or panic attacks; depression; and other psychiatric or neurological symptoms. (5)

Other symptoms that could be caused by chemical injury include multi-organ system malfunction; lower or upper respiratory problems, such as chronic sinus problems; multiple chemical sensitivity (MCS); liver or kidney problems; and fibromyalgia or other pain disorders.

Along with nervous system dysfunction, the temporal association of any of these conditions with toxic chemical exposure tends to support the theory that the overall cause of the client's injuries is a toxic insult to the body.

The illness you probably need to know the most about is MCS, both because it is common among chemical injury patients, and because doctors often don't recognize it in their patients. The MCS diagnosis is still rejected by many doctors in part because it is difficult to quantify objectively--but then, so are headaches.

Many doctors are not aware of the significant research that shows MCS is common and quite real. (6) MCS is similar to other disabling illnesses. People who have it can become very ill from exposures to everyday chemicals, such as perfumes, paint, pesticides, and cleaning products.

Under some conditions, MCS is recognized as a potentially disabling condition by the Social Security Administration, the U.S. Department of Housing and Urban Development, and the Americans with Disabilities Act. (7)

Documenting a chemical injury

There are various ways you can document the presence and course of a neurotoxic injury....