An autopsy case of a 52-year-old man suffering from chronic
manganese poisoning (
CMP) is reported with determination of the
manganese distribution in the brain. The patient had been working in a
manganese ore crushing plant since 1965. In 1967 he began to complain of difficulties in walking and diminished libido. Later, he developed various neuropsychiatric symptoms including euphoria, emotional incontinence, masked face, monotonous speech, "cock-walk",
increased muscle tone, weakness of upper and lower extremities,
tremor of the eye lids, and exaggeration of knee jerks. The major neuropathological change was degeneration of the basal ganglia, in which the pallidum was severely affected. The pallidum disclosed a loss and degeneration of nerve cells, which was especially marked in the medial segment, a prominent decrease of myelinated fibers, and moderate astrocytic proliferation. The substantia nigra was intact. Distribution of
manganese in the brain of the present case of
CMP was determined using flameless atomic absorption spectrometry and compared with control cases and also a case of
Parkinson's disease (PD). There was no significant difference between the control cases and the case of PD in average concentration of
manganese and its distribution in the brain. The present case of
CMP showed no elevation in average concentration of
manganese in the brain. However, there were some changes in its distribution. Thus, the continuance of
neurological disorders in
CMP is not linked to an elevated
manganese concentration itself in the brain.
CMP appears to be different from PD in neuropathology and
manganese behavior in brain.