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NEUROLOGY 1998;50:698-700
© 1998 American Academy of Neurology

Long-term progression in chronic manganism

Ten years of follow-up

C.-C. Huang, MD, N.-S. Chu, MD, PhD, C.-S. Lu, MD, R.-S. Chen, MD and D. B. Calne, DM, FRCPC

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

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

We studied the long-term clinical course of five patients with chronic manganese intoxication. The mean scores of the King's College Hospital Rating Scale for Parkinson's disease increased from 15.0 ± 4.2 in 1987 to 28.3 ± 6.70 in 1991 and then to 38.1 ± 12.9 in 1995. The deterioration was most prominent in gait, rigidity, speed of foot tapping, and writing. Tissue concentrations of manganese in blood, urine, scalp hair, and pubic hair returned to normal. Follow-up MRIs did not show paramagnetic high-signal intensity on T1-weighted images. The data indicate that clinical progression in patients with manganese parkinsonism continues even 10 years after cessation of exposure.

Supported by a grant from the National Science Council(NSC86-2314-B182A-048). PETs were also supported by the National Parkinson Foundation, the Parkinson Foundation of Canada, and The Movement Disorder Institute.

Received April 8, 1997. Accepted in final form September 5, 1997.




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