The acute neurotoxic effects of organic solvents are well described in human in vivo studies, as well as in experimental studies investigation the neurophysiological mechanisms. Many solvents disturb the fine-tuned balance of excitatory and inhibitory pathways in the brain shifting it into a more inhibitory state. During repeated, occupational exposures to solvents various physiological processes related to neuronal plasticity might be affected. The European Consensus group on chronic solvent encephalopathy (CSE) agreed that the behavioural phenotype of CSE is characterised by impairment performance in various cognitive tasks of domains. During the evaluation of workers suspected to suffer from CSE these different cognitive domains (e.g. attention, memory) and their sub-domains (e.g. delayed recall) should be assessed by standardised neuropsychological. Here, the national associations of neuropsychology should be consulted to provide the most suitable tests. The performance of the patients should be quantified by a scoring system that is based on the test scores of gender-, age-, and education-matched controls. The unweighted average score of the various tests should be used to classify the severity of CSE. During the examination factors like malingering, aggravation, insufficient effort, non-credible performance, or sub-optimal performance should be considered when evaluation the validity of the test performance. Possible comorbidities (e.g. major depression) should be treated and a re-evaluation should be offered. To avoid the occurrence of CSE cases in the future screening programs among solvent-exposed workers are needed, worldwide. Here the European Consensus group recommend a combination of standard questionnaires and neuropsychological screening tests. In general, the fact that occupational exposures to solvents at least in western countries generally decreased during the last decades should not be turned in an argument to reduce health surveillance of workers at risk for CSE.
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