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=== Neurological === Many common symptoms of MCS are neurological<ref name="Rossi2018" /><ref name="pmid30088144" /><ref name=":0">{{citation|chapter=1. Sensibilitá Chimica Multipla (MCS): Definizione di Caso|trans-chapter=1. Clinical features of the disease|url=https://www.infoamica.it/wp-content/uploads/2019/07/Consenso-MCS-20-giugno-2019.pdf|title=Consenso Italiano sulla Sensibilita Chimica Multipla (MCS). Documento di consenso e linee guida sulla Sensibilita Chimica Multipla (MCS) del Gruppo di Studio Italiano sulla MCS|trans-title=Italian Consensus on Multiple Chemical Sensitivity (MCS) -- Consensus Document and Guidelines on Multiple Chemical Sensitivity (MCS) by the Italian Workgroup on MCS | last =Grouppo di Italiano Studio MCS|location=Università degli Studi di Milano, Italy|date=2019-05-23}}</ref> (for example, "dizziness, seizures, head pain, fainting, loss of coordination"<ref name="Steinemann2018" />). And neurogenic inflammation and sensitization are widely thought to be mechanisms involved in causing, perpetuating and worsening MCS.<ref name=":0" /><ref name=":17" /><ref name=":18" /><ref name=":16" /> William Meggs said that [[Neuroinflammation|neurogenic inflammation]] was a well-defined pathophysiological process, in which chemical irritants triggered nerve fibers to release inflammatory mediators, which led to disease. In a 2017 review, he said that with MCS, an initiating chemical exposure (commonly a respiratory irritant or pesticide) was usually identified in association with the onset of the disease.<ref name=":16" /> Iris Bell researched brain-wave patterns in people with MCS. He showed, in several studies using [[Electroencephalography]] (EEG), that people with MCS often had certain abnormal brain wave patterns.<ref name=":4" /><ref>[https://europepmc.org/abstract/med/7778120 Schwartz GE, Bell IR, Dikman ZV, et al. EEG responses to low-level chemicals in normals and cacosmics. ''Toxicol Ind Health'' 1994; 10(4-5): 633-43.]</ref> For example, he found that women with MCS were more likely to have greater resting alpha waves than controls, which he said suggested the possibility of central nervous system hypo-activation.<ref>[https://www.sciencedirect.com/science/article/pii/S000632239700245X Bell IR, Schwartz GE, Hardin EE, Baldwin CM, Kline JP. Differential resting quantitative electroencephalographic alpha patterns in women with environmental chemical intolerance, depressives, and normals. ''Biol Psychiatry'' 1998; 43(5): 376-88.]</ref> Multiple neuro-imaging studies have shown that people with MCS often have other neurological abnormalities, including abnormal cerebral perfusion patterns, especially in the [[Autonomic nervous system|autonomic nervous system areas]].<ref name=":4" /><ref>[https://www.tandfonline.com/doi/abs/10.1080/15287399409531843 Callender TJ, Morrow L, Subramanian K. Evaluation of chronic neurological sequelae after acute pesticide exposure using SPECT brain scans. ''Toxicol Environ Health'' 1994; 41(3): 275-84.]</ref><ref>[https://www.sciencedirect.com/science/article/pii/B9780120597857500478 Callender TJ, Morrow L, Subramanian K, Duhon D, Ristov M. Three dimensional brain metabolic imaging in patients with toxic encephalopathy. ''Environ Res'' 1993; 60(2): 295-319.]</ref><ref>[https://europepmc.org/abstract/med/7778114 Heuser G, Mena I, Alamos F. NeuroSPECT findings in patients exposed to neurotoxic chemicals. ''Toxicol Ind Health'' 1994; 10(4-5): 561-71.]</ref><ref>[https://onlinelibrary.wiley.com/doi/abs/10.1002/hbm.20266 Hillert L, Musabasic V, Berglund H, Ciumas C, Savic I. Odor processing in multiple chemical sensitivity. ''Hum Brain Mapp'' 2006; 28(3): 172-82.]</ref><ref>[https://journals.sagepub.com/doi/abs/10.1177/074823379901500316 Ross GH, Rea WI, Johnson AR, Hickey DC, Simon TR. Neurotoxicity in single photon emission computed tomography brain scans of patients reporting chemical sensitivities. ''Toxicol Ind Health'' 1999; 15(3-4): 415-20.]</ref> These abnormalities have been documented both in studies using [[Positron emission tomography]] (PET) and [[Single-photon emission computed tomography]] (SPECT) scans.<ref name=":4" /><ref>[https://link.springer.com/article/10.1007/s10548-015-0453-3 Alessandrini M, Micarelli A, Chiaravalloti A, et al. Involvement of Subcortical Brain Structures During Olfactory Stimulation in Multiple Chemical Sensitivity. ''Brain Topogr 2'' 016; 29(2): 243-52.]</ref><ref>[https://link.springer.com/article/10.1007/s00259-014-2969-2 Chiaravalloti A, Pagani M, Micarelli A, et al. Cortical activity during olfactory stimulation in multiple chemical sensitivity: a (18)F-FDG PET/CT study. ''Eur J Nucl Med Mol Imaging'' 2015; 42(5): 733-40]</ref> In addition to people with MCS having documented neurological abnormalities, neuroplasticity is thought by some researchers to be an important mechanism in the disease. In 2018, a representative of the Royal Australasian College of Physicians said: “It could be a multiple chemical sensitivity phenomenon. It could be an irritable bowel phenomenon. It could be fibromyalgia... The common unifying features in all of these conditions is related to what we do know is happening, which is neuroplasticity in the nervous system. We know that, regardless of the initiating trigger—whether it was an overwhelming infection of a mould related organism or some other viral infection—it sets up, within the biological system called the nervous system, neuroplastic changes. They can be, and have been, documented by evidence based research. We can document that there are changes in the nervous system, and that change in the nervous system results in a change in the sensitivity and responsiveness of the human being.”<ref name="Hansard9Aug2018" />{{Rp|12}}<ref name=":40" />
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