目的：总结慢性锰中毒的临床及辅助检查特点，提高对本病的认识。方法回顾性分析4例慢性锰中毒的一般资料、病史、临床表现、实验室检查、电生理及影像学等临床资料。结果早期临床表现主要为轻度精神障碍和自主神经障碍，随后逐渐出现锥体外系的症状和体征。实验室检查无特异性，肌电图检查3例提示神经源性损害，1例正常，脑电图检查1例示全导慢波轻度增多，余3例正常。头颅MRI均见双侧对称性基底节神经核团受累。治疗前后尿锰水平的变化与临床表现无明显相关性。结论慢性锰中毒缺乏特异性临床表现，当患者出现轻度精神障碍、自主神经障碍伴或不伴有锥体外系神经障碍时，应注意本病的可能。该病以驱锰及对症支持治疗为主，多遗留震颤、肌张力增高等症状。%Objective To summarize the clinical and laboratory features of chronic manganese poisoning. Methods A retrospective analysis was conducted on the clinical data of 4 cases with chronic manganese poisoning, including gener⁃al information, medical history, clinical manifestations, laboratory examination such as electrophysiological and imaging. Results Patients with chronic manganese poisoning mainly presented with mild mental disorder and autonomic nerve dis⁃order during early stage and then gradually developed extrapyramidal symptoms and signs. The laboratory examination of chronic manganese poisoning lacked of specificity. EMG showed neurogenic damage in 3 cases and normality in 1 case. EEG showed slightly increased full guide slow wave in 1 case and normality in 3 cases. cranial MRI revealed the damag⁃es in bilateral symmetry of the basal ganglia nuclei in 4 cases of Chronic manganese poisoning. There was no significant correlation between the changes of urinary manganese level before or after treatment and the clinical manifestations. Conclusions Although there is lack of specific clinical manifestations of chronic manganese poisoning, the possibility of this disease should be considered when patients with mild mental disorders or autonomic nerve disorder with or without extrapyramidal symptoms. The main treatment of chronic manganese poisoning includes excretion of manganese, symp⁃tomatic and supportive treatment. Patients usually have the sequelae of tremor, muscle tension, and other symptoms.
展开▼
