The use of neuroimaging techniques for clinical detection of neurotoxicity: a review.

Although toxins exert their impact on a molecular level, they may yield molar effects by affecting areas large enough to be visualized by neuroimaging techniques. Therefore, neuroimaging of the brain may be used to render the macroscopic sequelae of neurotoxins visible. Toxic agents may induce brain edema or atrophy, demyelination, infarctions, calcifications, hemorrhages, or changes of perfusion, metabolism or receptor density. Although they do not readily disclose their nature, clues as to the offending agent may in some instances be gleaned from the pattern, distribution, and appearance of the cerebral changes. Intoxication, however, has always to be proved or substantiated independently by appropriate means. This paper deals with the extent and certainty to which conclusions as to some of the most common offending substances may be drawn from pictures of the brain.