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[Follow-up study after enteral manganese poisoning: clinical, laboratory and neuroradiological findings]
1Psychiatrische Klinik und Poliklinik, Georg-August-Universität Göttingen.
Abstract:
Manganese intoxication is an unusual, severe form of intoxication. This report deals with a patient now 80 years old who accidentally ingested a solution of potassium permanganate for a period of at least 4 weeks 14 years ago. Since then, the patient suffers from a mild parkinsonian syndrome and distally accentuated polyneuropathies. Psychiatric disorders, especially demential or depressive symptoms, were not observed. Manganese analysis of his hair still shows a clear increase in manganese concentration. The MRI of his brain showed no pathological changes, in particular none of those often described with symmetric signal elevation in T1 in the area of the basal ganglia. In this study, we present clinical, laboratory, and neuroradiological findings. Unusual in this case with a short exposition is the long duration and clinical improvement without L-dopa treatment.
Insights
This case study details an 80-year-old patient with mild parkinsonian syndrome and polyneuropathies following accidental manganese intoxication. Remarkably, the patient improved clinically without L-dopa treatment, despite elevated hair manganese levels.
Area of Science:
- Neurotoxicology
- Environmental Medicine
- Neurology
Background:
- Manganese intoxication is a rare but severe condition.
- Accidental ingestion of potassium permanganate can lead to chronic manganese exposure.
- Long-term neurological sequelae are a concern in manganese toxicity.
Observation:
- An 80-year-old patient accidentally ingested potassium permanganate for at least 4 weeks, 14 years prior.
- The patient developed mild parkinsonian syndrome and distal polyneuropathies.
- No psychiatric disorders, including dementia or depression, were noted.
Findings:
- Hair analysis revealed persistently elevated manganese concentrations.
- Brain MRI showed no pathological changes, notably lacking the typical basal ganglia signal alterations.
- Clinical improvement occurred without the use of Levodopa (L-dopa) medication.
Implications:
- This case highlights the potential for long-term neurological effects from manganese exposure.
- The absence of typical MRI findings and improvement without L-dopa offers unique insights into manganese neurotoxicity.
- Further research is warranted to understand the mechanisms of manganese-induced parkinsonism and recovery.