{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:30:56Z","timestamp":1786728656135,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Toxic encephalopathy is a spectrum of central nervous system disorders caused by exposure to toxins, especially from occupational workplace. Polyvinylchloride (PVC) is a synthetic chemical polymer that is used widely in daily activities of living. PVC is produced by polymerization of monomer units of vinyl chloride. Its manufacturing requires multiple procedures and additives for heat and light stabilization involving heavy metals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>In this novel case series, we present the diverse clinical presentation of 10 patients, working in plastic recycling factory having inhalational exposure to PVC fumes, manifesting as acute toxic encephalopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>All the patients were screened for the causes of acute encephalopathy including heavy metals, methanol poisoning, and organotins along with arterial blood gas analysis, brain imaging, and electroencephalogram. Memory loss, confusion, vertigo, headache, and nausea were complained in all the patients while seizure occurred in three patients. Neurocognitive status was grossly impaired in all the patients. Metabolic acidosis in presence of hyponatremia and\/or hypokalemia was observed in nine cases. Five of the patients were having evidence of white matter involvement in brain imaging. The screening for heavy metal, methanol, and organotin were negative. Hemodialysis was done in six patients. Recovery was good in everyone and the average discharge was by 10.8 days (range: 2\u201325 days). All the patients were symptom-free at 3-months follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Early suspicion and aggressive management can have favorable outcome in PVC toxic encephalopathy. Occupational hazards due to PVC toxicity are increasing in the present industrial era but it is very less identified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.378675","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T04:18:06Z","timestamp":1692850686000},"page":"531-535","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Acute Toxic Encephalopathy in Occupational Exposure with Polyvinyl Chloride (PVC) Fumes"],"prefix":"10.4103","volume":"71","author":[{"given":"Rajesh","family":"Verma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajarshi","family":"Chakraborty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prithvi","family":"Giri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-23-20240907","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5491\/SHAW.2012.3.4.243","article-title":"Toxic encephalopathy","volume":"3","author":"Kim","year":"2012","journal-title":"Saf Health Work"},{"key":"R3-23-20240907","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/0002-9343(81)90763-4","article-title":"Occupational carcinogenesis: The Louisville experience with vinyl chloride-associated hepatic angiosarcoma","volume":"70","author":"Dannaher","year":"1981","journal-title":"Am J Med"},{"key":"R4-23-20240907","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1590\/S0100-40422012000200037","article-title":"The contributions of Henri Victor Regnault in the context of organic chemistry of the first half of the nineteenth century","volume":"35","author":"Reif-Acherman","year":"2012","journal-title":"Qu\u00edmica Nova"},{"key":"R5-23-20240907","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/BF00405418","article-title":"Vinyl chloride disease\u2014Neurological disturbances","volume":"52","author":"Langauer-Lewowicka","year":"1983","journal-title":"Int Arch Occup Environ Heath"},{"key":"R6-23-20240907","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1055\/s-2007-1001207","article-title":"Neurologische und psychiatrische St\u00f6rungenbei der Vinylchlorid-Krankheit [Neurologic and psychiatric disorders in vinyl chloride disease]","volume":"58","author":"Podoll","year":"1990","journal-title":"Fortschr Neurol Psychiatr"},{"key":"R7-23-20240907","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1001\/jama.1967.03130080019005","article-title":"Occupational acroosteolysis. Report of 31 cases","volume":"201","author":"Wilson","year":"1967","journal-title":"JAMA"},{"key":"R8-23-20240907","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1289\/ehp.772125","article-title":"Inhalation toxicity of vinyl chloride and vinylidene chloride","volume":"21","author":"Lee","year":"1977","journal-title":"Environ Health Perspect"},{"key":"R9-23-20240907","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1289\/ehp.00108579","article-title":"Vinyl chloride: Still a cause for concern","volume":"108","author":"Kielhorn","year":"2000","journal-title":"Environ Health Perspect"},{"key":"R11-23-20240907","doi-asserted-by":"crossref","first-page":"e002785","DOI":"10.1136\/bmjopen-2013-002785","article-title":"The long-term effects of occupational exposure to vinyl chloride monomer on microcirculation: A cross-sectional study 15 years after retirement","volume":"3","author":"Lopez","year":"2013","journal-title":"BMJ Open"},{"key":"R12-23-20240907","first-page":"128","article-title":"Magnetic resonance imaging of leukoencephalopathy in amnestic workers exposed to organotin","volume":"57","author":"Lee","year":"2016","journal-title":"Neuro Toxicol"},{"key":"R13-23-20240907","first-page":"747","article-title":"Toxic encephalopathy","volume":"13","author":"Valk","year":"1992","journal-title":"AJNR Am J Neuroradiol"},{"key":"R14-23-20240907","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.4172\/2161-0495.1000400","article-title":"Polyvinyl chloride (PVC) acting as occupational hazard in a factory worker presented with acute toxic encephalopathy: A case report","volume":"8","author":"Khosya","year":"2018","journal-title":"J Clin Toxicol"},{"key":"R16-23-20240907","first-page":"663","article-title":"Central pontine myelinolysis associated with hypokalaemia in anorexia nervosa","volume":"75","author":"Keswani","year":"2004","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R17-23-20240907","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.diabres.2004.08.005","article-title":"Central pontine and extrapontine myelinolysis associated with type 2 diabetic patient with hypokalemia","volume":"68","author":"Shintani","year":"2005","journal-title":"Diab Res Clin Prac"},{"key":"R18-23-20240907","doi-asserted-by":"crossref","first-page":"ii2","DOI":"10.1136\/jnnp.2005.069245","article-title":"EEG in the diagnosis, classification, and management of patients with epilepsy","volume":"76","author":"Smith","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R19-23-20240907","first-page":"452","article-title":"CT and MR imaging findings in methanol intoxication","volume":"27","author":"Blanco","year":"2006","journal-title":"AJNR Am J Neuro Radiol"}],"container-title":["Neurology India"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.378675","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:29:59Z","timestamp":1786724999000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.378675"}},"subtitle":["A Case Series"],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/0028-3886.378675","relation":{},"ISSN":["0028-3886"],"issn-type":[{"value":"0028-3886","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}