Toxic Encephalopathy

Toxic encephalopathy is a neurological disorder caused by exposure to toxic substances. Toxic encephalopathy can occur following acute or chronic exposure to toxic substances, such as diesel exhaust, chlorinated solvents, welding fumes and ammonia. Exposure to toxic substances can lead to a variety of symptoms and can permanently damage the brain. Currently, treatment focuses mainly on controlling the symptoms of toxic encephalopathy.

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    Diesel Injury Law has received numerous inquiries from diesel-exposed workers suffering from memory deficits, balance issues, tremors and personality changes. Some describe acute episodes of carbon monoxide poisoning and then a rather sudden development of the symptoms.  Others describe longstanding exposures to toxins over time and the development of these symptoms.

    After the exposed workers begin to notice symptoms, they typically undergo a round of diagnostic tests which often leave their treating doctor perplexed. Because of the accompanying personality changes, these workers are often treated with prescription drugs like Prozac and sent on their way. They don’t receive a firm diagnosis. What may be happening in these cases is a condition called toxic encephalopathy.


    Encephalopathy is a general term to describe abnormal brain function caused by toxins in the brain. The most prominent characteristic of toxic encephalopathy is an altered mental status. Toxic encephalopathy can present a very broad spectrum of symptoms that range from mild to severe, and may include:

    • Memory loss
    • Lethargy
    • Decreased concentration and consciousness
    • Muscle twitching or tremors
    • Subtle personality changes
    • Dementia
    • Seizures
    • Coma
    • Death

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    Acute Exposures

    Acute toxic encephalopathy reflects an acute cerebral dysfunction. There is usually a rapid onset of symptoms, typically days or weeks after exposure to organic solvents or gases (such as carbon monoxide, hydrogen sulfide, and cyanide). Acute toxic encephalopathy can be reversible when the abnormalities are detected and treated right away. Symptoms may include lightheadedness, dizziness, headaches, nausea, and alterations in the level of consciousness.

    Chronic Exposures

    Regular exposure to toxic solvents or gases over a number of years puts an individual at higher risk for developing toxic encephalopathy. Chronic encephalopathies are characterized by chronic mental status alteration, resulting in memory loss and changes in mood and affect. In most cases, symptoms are slowly progressive. They result from permanent, usually irreversible, structural changes within the brain itself. However, some may be halted or reversed by early detection and treatment.



    In order to be diagnosed with toxic encephalopathy, see a doctor qualified in occupational medicine or a specialist in neurotoxins. Generally, toxic encephalopathy is not difficult to diagnose if a patient develops a well-described history of symptoms after exposure to a well-known neurotoxin, or if other workers at the same site develop similar symptoms. The more difficult (and more common) situation is when an individual presents symptoms and has either an unclear history of exposure or an apparently trivial exposure to a known or suspected neurotoxin. Neuro-psychological testing is often required to support the diagnosis.

    A patient’s exposure history is particularly important for diagnosing a toxic encephalopathy. A patient’s exposure history is also significant for legal purposes. For example, in McNeel v. Union Pac. R.R., 276 Neb. 143, (2008), the defendant railroad was found not guilty because plaintiff’s expert could not identify any specific cause for the diagnosis of toxic encephalopathy. In other words, the plaintiff lost because he couldn’t identify the specific toxin that caused his occupational illness. However, in Hose v. Chi. Nw. Transp. Co., 70 F.3d 968 (8th Cir. 1995), a jury awarded plaintiff $1,333,279.31 for personal injuries resulting in toxic encephalopathy. The primary difference between these two cases is that the plaintiff in Hose was able to identify that he was exposed to substantial amounts of fumes and dust containing manganese while working as a welder for Chicago and North Western Transportation Company. Thus, a history of exposure is imperative in toxic encephalopathy cases.

    If you or a loved are suffering from some of the symptoms listed above, contact Diesel Injury Law today for a free consultation with an experienced toxic tort attorney.  We will consult with our experts and determine if those symptoms are work-related and if so, bring a claim on your behalf.

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    Hughes Law Offices is providing case histories to inform visitors about actual case fact patterns and rulings.
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    Railroad carman died of pulmonary fibrosis following 18 years of welding.



    Locomotive engineer in his early 60’s developed diesel asthma.



    Railroad mechanic diagnosed with squamous cell oropharyngeal cancer.



    Trainman died of nasopharyngeal cancer as a result of working on-board locomotives filled with diesel exhaust.



    Retired railroad employee died of lung cancer as a result of workplace asbestos exposure.



    61 year old railroad conductor diagnosed with interstitial fibrosis and an increased risk of lung cancer as a result of exposure to diesel exhaust.

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