Neurológia pre prax 2/2013

Parkinsonian syndrome induced by long-term manganese exposure

In our case report we describe a parkinsonian syndrome in a seventy-year old patient who was exposed to manganese on a long-term basis as a worker in a foundry of weapon steel from his twenty-six to sixty years of age. First symptoms of parkinsonian syndrome in this patient appeared at the age of forty-seven. Presently, the neurological findings include rigidity and bradykinesia in the upper extremities, hesitation, propulsion and absence of synkinesias during walk, hypomimia, postural instability. Laboratory findings were within normal limits, psychological investigation did not show any cognitive deficit. Dopaminergic reactivity was only partial. On magnetic resonance imaging of the brain, there was decreased signal in the globus pallidus on a T2*-weighted sequence (correlate of the possible exposition to metal). On the basis of these findings we suggest that the cause of the parkinsonian syndrome in this patient is a chronic manganese poisoning – so called manganism.

Keywords: parkinsonian syndrome, manganese, exposure.