In 1979a 60-year-oldmale electricianexposedto vibration from a hand-held hammer-drill an hour a day for 22 years noted numbness in fingers II-IV on both hands. The symptoms increased over a period of threeyears. Electromyography revealed carpaltunnel syndrome. During 1982 the patient noticed numbness, not only in his hands, but also in his arms. The sensory disturbances in his arms were neither uniformly nor segmentally distributed but appeared to follow singlenervesand thus indicated polyneuropathy. A rectalbiopsyshowedamyloiddeposits. Since therewasno detectable causefor the amyloid disease, it was regarded as primary amyloidosis. The exposure to hand-arm vibration was regarded as a factor modifying the onsetand possibly alsothe severity of symptoms in the hands. The social insurance authorities agreed to pay half the accepted workmen`s compensation to the patient for the initial two years of sick leave from work. After the two yearsthe disease itselfwasregarded as being"responsible" for all symptoms.

Key terms amyloid polyneuropathy; amyloidosis; carpal tunnel syndrome; case report; occupational disease; paresthesia; vibration; vibration exposure; workmens compensation