BMJ Case Reports 2017; doi:10.1136/bcr-2017-223074
  • Rare disease

Unusual case of anxiety: trichloroethylene neurotoxicity

  1. Joshua Au Yeung
  1. Department of Medicine, Pennine Acute Hospitals NHS Trust, Oldham, Manchester, UK
  1. Correspondence to Dr Joshua Au Yeung, j.auyeung{at}
  • Accepted 9 December 2017
  • Published 22 December 2017


I present an uncommon case of recurrent, intractable anxiety that was presented acutely and slowly evolved into a chronic debilitating condition. A young previously fit and healthy 24-year-old patient presents with somewhat atypical symptoms of anxiety. Full medical work-up including examination, blood, ECG electrocardiogram, electroencephalogram and CT of the head was unremarkable. When the history was explored in detail, it was revealed he worked in the navy and was exposed to a neurotoxic solvent, trichloroethylene. This case highlights the importance of eliciting a detailed occupational history, particularly paying attention to patient demographics such as occupation and presenting symptoms that do not readily fit into diagnostic criteria.


  • Contributors Consent, reviewing the case and writing the case all carried out by the author

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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