Motor neuron disease in textile factory workers

Three patients with wasting and weakness of the small muscles of both hands and clawing of the fingers, with visible fasciculations are described. Deep tendon reflexes were increased in the four limbs. No cranial nerve involvement or signs of pseudobulbar palsy were found. Electromyographic findings of spontaneous polyphasic activity, fibrillations and diminished interference patterns with giant potentials, confirmed the diagnosis of a spinal form of motor neuron disease. The clinical course of our patients was quite slow; a clinical follow-up of ~ 1 year after diagnosis in each case showed no progression, or even some improvement, following retirement from the textile factory work. The patients were employed in maintenance work, like machine lubrication and cleaning, and had been exposed to many chemicals used in the textile industry, including lubrication oils, color vapors and other substances. The occurrence of motor neuron disease in textile factory workers again raises the issue of chemical factors contributing to the pathogenesis of this severe disorder.