Manganese neurotoxicity presenting with depression, psychosis and catatonia.

摘要

Locura manganica or "manganese madness" is a discrete Parkinson-like syndrome documented in the last century that occurs with chronic exposure to manganese (Mn), an essential element abundant in the Earth's crust. It is especially well known in Latin America, where the majority of Mn is mined. Acute Mn toxicity in the form of acute psychosis was documented as early as 1837 in the United States, produced by rapid inhalation of dust containing high concentrations of Mn. Neuropsychiatric symptoms are varied and include emotional lability, visual and auditory hallucinations, nervousness, irritability, and compulsive acts, which subside after several weeks and are replaced by muscular weakness and rigidity, postural tremor, dys-arthria, gait disorders, and headaches. The primary route of toxic exposure is inhalation of Mn-containing aerosols or transport of particulate matter by the olfactory bulb. Onset is insidious, progression is chronic, and the severity of symptoms is modulated by individual susceptibilities as well as by the length and dose of exposure. Symptoms can continue to progress more than 10 years after exposure has stopped and Mn has been cleared from hair, skin and blood cells.