The neurological findings in 50 children and adolescents, known to have been sniffing leaded gasoline for periods of 6 months to over 5 years, were analysed. 46/50 patients (92%) had abnormal signs on initial examination: i) 34/46 patients (73%) had abnormally brisk deep reflexes, ii) 31/46 (67%) had cerebellar signs, 29 of these 31 patients showing intention tremor and iii) 28/46 (60%) had postural tremor. 49/50 patients (98%) had blood lead (Pb) levels > 40 pgldl and in 22 the blood Pb was 2

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... 0 pg/dl. The mean blood Pb levels were significantly higher (p 4 0.05) in those with a) abnormally brisk deep reflexes, b) marked intention tremor, c) ataxic stance and d) ataxic gait, than in those without these findings. 39 patients received chelation therapy. Regardless of therapy, of the 46 patients with abnormal signs, resolution occurred within 8 weeks in all but one; this patient continues to have abnormal signs a year later. Our report draws attention to the neurological manifestations in chronic leaded gasoline sniffers. The possibility of the abuse of a solvent such as leaded gasoline should be considered in chfldren and adolescents showing abnormally brisk deep reflexes, cerebellar dysfunction and postural tremor.