1,2-Dichloroethane-induced toxic encephalopathy: A case series with morphological investigations

• We made a morphological investigation of a case series of DCE toxic encephalopathy.
• The main clinical manifestation is headache accompanied by intracranial hypertension.
• The neuroimaging features of 1,2-dichloroethane toxic encephalopathy are showed.
• The patients should be treated mainly by dehydrating agents and glucocorticoids.
• Early diagnosis and prompt treatment lead to a good outcome.

1,2-Dichloroethane (DCE) is commonly used as an industrial organic solvent and causes occupational diseases. Toxic encephalopathy is the most common and serious disorder resulting from DCE intoxication. Five patients who worked in shoemaking, pipemaking or a paint factory were identified as suffering from severe encephalopathy due to DCE intoxication. DCE-induced toxic encephalopathy manifests as various neurological deficits, with changes observable by neuroimaging. The main clinical manifestation is headache accompanied by intracranial hypertension. The typical cranial CT/MR scan of DCE toxic encephalopathy shows extensive brain edema and diffuse, symmetric, abnormal signal intensities in the cerebellar dentate nucleus, basal ganglia, and white matter in the bilateral cerebral hemispheres. The diagnosis of DCE toxic encephalopathy can be confirmed by the typical clinical and neuroimaging characteristics together with a history of exposure to substances contaminated with DCE. Dehydrating agents and glucocorticoids are the primary treatments. With early diagnosis and prompt treatment, promising results and recovery can be achieved. Effective prevention is expected to reduce the incidence of DCE toxic encephalopathy.