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[Brain MRI associated with chronic hepatic failure and hypermanganism]

M Aissi1, C Nifle, S Roussin Bretagne

  • 1Service de neurologie, unité neurovasculaire, centre hospitalier de Versailles, hôpital André-Mignot, université de Versailles Saint-Quentin-en-Yvelines, 1, rue Richaud, 78000 Versailles, France.

Revue Neurologique
|June 6, 2009
PubMed
Abstract

Insights

Hypermanganism, or manganese poisoning, can cause neurological issues and distinctive brain MRI findings. This case highlights bipallidal T1 hyperintensities as a potential indicator, even without direct manganese exposure.

Area of Science:

  • Neurology
  • Radiology
  • Toxicology

Background:

  • Manganese exposure can lead to neurological symptoms and characteristic brain MRI findings.
  • Endogenous manganese poisoning, particularly in chronic hepatic failure, can mimic exogenous poisoning.
  • Bipallidal T1 hyperintensities on MRI are a key radiological sign associated with manganese toxicity.

Observation:

  • A case of a 41-year-old HIV and HCV-positive man with psychomotor impairment and bipallidal T1 hyperintensities on MRI is presented.
  • Diagnosis of hypermanganesemia was confirmed through blood sample analysis.
  • The patient's condition presented without a clear history of exogenous manganese exposure.

Findings:

  • Hypermanganesemia was diagnosed in a patient with psychomotor impairment and specific MRI findings.
  • Literature review covered both exogenous and endogenous causes of hypermanganesemia.
  • Differential diagnosis for bipallidal T1 hyperintensities was discussed.

Implications:

  • Bipallidal T1 hyperintensities on brain MRI can be indicative of hypermanganesemia.
  • This finding is relevant even in non-specific neurological presentations like psychomotor impairment.
  • The study underscores the importance of considering manganese toxicity in neurological disorders with characteristic radiological signs.

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