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Levodopa failure in chronic manganism

Department of Neurology (Drs. Lu, Huang, and Chu), Chang Gung Medical College and Memorial Hospital, Taipei, Taiwan, and the Neurodegenerative Disorders Centre (Dr. Calne), University of British Columbia, Vancouver, BC, Canada.

We report a placebo-controlled study of levodopa in four patients with extrapyramidal deficits caused by chronic manganese intoxication. Their parkinsonism and dystonia had progressed slowly over a period of 5 years after they left the site of exposure. Initially the patients appeared to respond to levodopa in open observations, but this apparent benefit was not sustained. This short-term, double-blind study indicates that their parkinsonism and dystonia failed to respond to levodopa.

Address correspondence and reprint requests to Dr. Chin-Song Lu, Department of Neurology, Chang Gung Memorial Hospital, 199, Tung Hwa North Road, Taipei, Taiwan.

Supported in part by the National Parkinson Foundation (Miami), the Dystonia Medical Research Foundation, and the Medical Research Council of Canada.

Received December 27, 1993. Accepted in final form February 21, 1994.

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