[Chronic toluene intoxication and hyperkinésie volitionnelle].

Hyperkinésie volitionnelle is one of the involuntary movements discriminated from intention tremor. It occurs idiopathically and with cerebral infarction, head trauma, brain tumors, multiple sclerosis, hepatolenticular degeneration and polyneuropathy. Here, we report a case of toluene intoxication presenting hyperkinésie volitionnelle. A 28-year-old painter noticed a tremor of the upper extremities on December 1979. The tremor occurred both in posture and in voluntary movements. The tremor gradually developed and appeared in the legs in May 1980. Slight titubation of the trunk and head was marked in sitting posture. He showed staggering of gait. On August 1980, he exhibited slurred speech. He was admitted to the Department of Neurology of Chiba University Hospital on January 19th, 1981. Neurological examination revealed slight mental deterioration, pendular nystagmus, bradylalia, 4-5 c/s violent postural tremor of the upper extremities, action myoclonus, head and truncal titubation, mild leg tremor in sitting posture. The tremor increased terminally on finger to nose testing, and showed fast, coarse, convulsive movement (movement oppositionniste). But there was no dysmetria. The involuntary movements, above mentioned, were summarized as hyperkinésie volitionnelle. Muscle tone was hypotonic. Muscle weakness and atrophy were not seen. Deep tendon reflexes were all exaggerated, but there was no pathological reflex. He showed wide-based ataxic gait. Sensory and autonomic functions were normal. Blood, urine and cerebrospinal fluid analysis appeared normal. Electroencephalography showed 40-50 microV, 9-10 c/s alpha waves with a few fast waves.(ABSTRACT TRUNCATED AT 250 WORDS)