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January 22, 2014: Manganese Neurotoxicity

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Brought to you by the Residents & Fellows Section of Neurology®.

January 22, 2014

Manganese is an essential mineral and plays critical roles in many enzymatic pathways. Exposure to excess manganese, either ingested or inhaled, can lead to accumulation in the central nervous systems (CNS) and a defined poisoning syndrome. The association was first described in 1837 by James Couper who detailed peculiar motor symptoms in Scottish men grinding manganese dioxide ore [1]. Today, populations at risk for manganese toxicity include welders, chemical and industrial workers handling manganese alloys, and those exposed to pesticides and contaminated drinking water. Toxicity in children can resemble lead neurotoxicity with cognitive impairment with behavioral and motor delays [2]. In adults, symptoms can include cognitive slowing, headache, mood changes, and with higher intensity exposures an atypical parkinsonism called manganism. The clinical symptoms may reverse if the toxic exposure is removed.

References:

  1. Lucchini, Roberto; Martin, Christopher; Doney, Brent. From manganism to manganese-induced parkinsonism: A conceptual model based on evolution of exposure. Neuromol Med 2009; 11: 311-321.
  2. Zoni, Silvia; Lucchini, Roberto. Manganese exposure: cognitive, motor and behavioral effects on children: a review of recent findings. Curr Opin Pediatr 2013; 25: 255-260.

Submitted by: Adam Numis, MD, University of California, San Francisco

Dr. Numis is a member of the Resident and Fellow Section of Neurology

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