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Neurotoxicology: a clinical systems-based review
  1. Frederick W Vonberg1,
  2. Peter G Blain2
  1. 1National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
  2. 2Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Frederick W Vonberg, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; frederick.vonberg{at}


Neurological disease caused by toxins is widespread but under-recognised. Despite increasing public interest and a growing number of novel potential neurotoxins, diagnosis of neurotoxic disease is often delayed or missed, resulting in poorer patient outcomes. This article discusses neurotoxic syndromes using a systems-based approach, focusing on environmental and occupational agents. We do not discuss recreational drugs, pharmaceutical agents or developmental neurotoxins in detail. We aim to provide neurologists with a working understanding of the scenarios in which a clinical presentation may be due to a neurotoxin and how to approach confirmation of the diagnosis.


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  • Contributors Both authors were involved in the design and conception of this paper. FWV wrote the first draft and subsequent revisions and PGB edited, critically revised and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests FWV is supported by a Guarantors of Brain postdoctoral clinical fellowship.

  • Provenance and peer review Provenance and peer review. Commissioned. Externally peer reviewed by Aaron Berkowitz, San Francisco, USA.