The neurotoxicological aspects of the toxic oil syndrome (TOS) in Spain.

The pathomechanism of the Spanish mass oil poisoning, which affected more than 20,000 people in the spring of 1981 and has so far caused more than 500 deaths, has not yet been clarified. Subsequent to a toxic-allergic initial phase of the disease with fever as well as lung and skin manifestations, 10 to 20% of the patients, after passing through an interval of reduced symptoms, entered a second disease phase characterized by marked vasculitis and fibrosis in diverse organ systems. The most frequent manifestation type involved in this connection was a severe neuromyopathy with pronounced joint contractures and skin alterations. A survey of the disease course is presented on the basis of our own examinations at the Centro Especial Ramon y Cajal as well as morphological studies on nerve-muscle and brain tissue, chemical analysis studies with oil samples from affected families and the literature available so far.