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Elemental mercury poisoning probably causes cortical myoclonus
Mona Ragothaman1, Girish Kulkarni, Valappil V Ashraf
1Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India.
Summary
Elemental mercury toxicity can cause tremors and neurological issues. A case study shows that surgically removing mercury deposits reversed severe myoclonus and ataxia in a patient, highlighting a potentially treatable cause of neurological deficits.
Area of Science:
- Neurology
- Toxicology
- Neuroscience
Background:
- Mercury toxicity is a known cause of neurological symptoms, including postural tremors (mercurial tremors) and cerebellar dysfunction.
- Elemental mercury exposure can lead to severe and progressive neurological deficits.
Observation:
- A 23-year-old woman developed disabling generalized myoclonus and ataxia two years after self-injecting elemental mercury.
- Electrophysiological studies suggested the myoclonus was of cortical origin, a presentation not previously described in mercury poisoning.
Findings:
- The patient's neurological deficits, including myoclonus and ataxia, progressed over two years.
- Surgical removal of subcutaneous elemental mercury deposits led to significant improvement in her symptoms.
Implications:
- Cortical myoclonus is a newly identified manifestation of elemental mercury poisoning.
- Promptly inquiring about elemental mercury exposure in patients with unexplained jerking movements is crucial for diagnosis and treatment.
- Early intervention and surgical removal of mercury deposits can potentially reverse severe neurological damage.
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