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April 01, 2014; 82 (13) Historical Neurology

Myelopathy among zinc-smelter workers in Upper Silesia during the late 19th century

Douglas J. Lanska, Bernd Remler
First published March 31, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000270
Douglas J. Lanska
From Neurology Service (D.J.L.), Veterans Affairs Medical Center, Great Lakes VA Healthcare System, Tomah; Departments of Neurology and Ophthalmology (B.R.), Medical College of Wisconsin, Milwaukee; and Zablocki Veterans Affairs Medical Center (B.R.), Great Lakes VA Healthcare System, Milwaukee, WI.
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Bernd Remler
From Neurology Service (D.J.L.), Veterans Affairs Medical Center, Great Lakes VA Healthcare System, Tomah; Departments of Neurology and Ophthalmology (B.R.), Medical College of Wisconsin, Milwaukee; and Zablocki Veterans Affairs Medical Center (B.R.), Great Lakes VA Healthcare System, Milwaukee, WI.
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Myelopathy among zinc-smelter workers in Upper Silesia during the late 19th century
Douglas J. Lanska, Bernd Remler
Neurology Apr 2014, 82 (13) 1175-1179; DOI: 10.1212/WNL.0000000000000270

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Abstract

Zinc-induced myeloneuropathy was recently (re)discovered and its pathophysiology elaborated as resulting from secondary copper deficiency. However, myelopathy was a recognized problem among European zinc-smelter workers in the late 19th century, although these early reports have been overlooked in recent studies and reports. The purpose of this article is to translate and review German-language reports of myelopathy among zinc-smelter workers in Upper Silesia (now southern Poland) by Schlockow from the 1870s. Disease manifestations among zinc-smelter workers developed after sustained zinc exposure over many years. The earliest symptoms were sensory and included paresthesias, dysesthesias, allodynia, and formication in the lower extremities, particularly the feet. Workers ultimately developed a clinical picture resembling subacute combined degeneration of the spinal cord with a spastic-ataxic gait with prominent proprioceptive impairment, sensory disequilibrium, and rombergism.

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  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received September 18, 2013.
  • Accepted in final form December 13, 2013.
  • © 2014 American Academy of Neurology
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