Parkinsonism due to manganism in a welder: Neurological and neuropsychological sequelae
Parkinsonism due to manganism in a welder: Neurological and neuropsychological sequelae
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DOI：
10.1016/j.neuro.2005.10.011
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发表时间：
2006-05-01
期刊：
影响因子：
3.4
通讯作者：
Schulz, Paul E.
中科院分区：
文献类型：
--
作者：
Bowler, Rosemarie M.;Koller, William;Schulz, Paul E.
一名33岁的焊工暴露于含锰（Mn）的焊接烟雾3年，神经科医生因认知和运动主诉就诊。他表现出帕金森病的体征和症状，包括震颤、运动迟缓、步态障碍和齿轮强直。然而，他很年轻，注意力不集中，健忘，发现左旋多巴没有帮助，走路像公鸡走路，所有这些都表明锰中毒。事实上，他的血清和尿液中的锰水平升高，他的大脑MRI显示双侧基底神经节（苍白球）T1加权信号强度增加，与锰沉积一致。两年后，他接受了全面的神经心理学测试。临床病史显示轻度震颤和情绪障碍，伴有易怒、焦虑和抑郁，伴有精神病特征。他表现出认知灵活性、信息处理和速度方面的缺陷，并且运动速度大大降低，这与额皮质下过程一致。这些发现支持了早期发作的帕金森氏症的诊断焊接，（c）2006年爱思唯尔公司。All rights reserved.
A 33-year-old welder with 3 years of exposure to manganese (Mn) bearing welding fumes was seen by neurologists for cognitive and motor complaints. He exhibited signs and symptoms of Parkinson's disease, including tremor, bradykinesia, gait disturbance and cogwheel rigidity. However, he was young and had significant inattention and forgetfulness, had found levodopa unhelpful and moved with a cock-walk gait, all of which suggested manganism. His serum and urine levels of Mn were, in fact, elevated, and his brain MRI had increased T1-weighted signal intensities in the basal ganglia bilaterally (globus pallidus) consistent with Mn deposition. Two years later, he underwent comprehensive neuropsychological testing. Clinical history indicated a mild tremor and emotional dysfunction with irritability, anxiety, and depression with psychotic features. He showed deficits in cognitive flexibility, information processing and speed, and greatly reduced motor speed, which are consistent with a fronto-subcortical process. These findings support a diagnosis of early onset parkinsonism from welding, (c) 2006 Elsevier Inc. All rights reserved.