title: The neuropsychiatric sequelae of mercury poisoning. The Mad Hatter's disease revisited.
abstract: BACKGROUND
  The detailed effects of mercury poisoning on cognitive function, brain anatomy and regional brain function are largely unknown. We report the case of a 38-year-old man who was exposed to toxic levels of inorganic mercury.
  
  
  METHODS
  Four years after exposure, the patient was assessed using magnetic resonance imaging (MRI), single-photon emission computerised tomography (SPECT) and detailed neuropsychological evaluation.
  
  
  RESULTS
  The patient developed a myriad of physical and psychiatric complaints, including stomatitis, muscle spasm, tremor, skin rash and the psychiatric syndrome known as 'erythism' (Mad Hatter's disease). Neuropsychological evaluation revealed marked and significant deficits of attention concentration, particularly when under time pressure. The MRI scan was unremarkable; however, SPECT revealed hypermetabolism of the posterior cingulate
  
  
  CONCLUSIONS
  Mercury poisoning appeared to result in a dysregulation of posterior cingulate cortex, which was associated with attention/concentration deficits and marked anxiety/agitation.
authors.affiliation: MRC Brain Metabolism Unit, Royal Edinburgh Hospital.
authors.forename: R E
authors.initials: RE
authors.lastname: O'Carroll
authors.forename: G
authors.initials: G
authors.lastname: Masterton
authors.forename: N
authors.initials: N
authors.lastname: Dougall
authors.forename: K P
authors.initials: KP
authors.lastname: Ebmeier
authors.forename: G M
authors.initials: GM
authors.lastname: Goodwin
mesh_terms: D000328:Adult; D001288:Attention / Q000187:drug effects; D001921:Brain / Q000187:drug effects / Q000473:pathology; D004734:Energy Metabolism / Q000187:drug effects; D005659:Fungicides, Industrial / Q000506:poisoning; D006179:Gyrus Cinguli / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D008630:Mercury Poisoning / Q000175:diagnosis / Q000523:psychology*; D009460:Neurologic Examination / Q000187:drug effects; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D010663:Phenylmercury Compounds / Q000506:poisoning; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005659:Fungicides, Industrial; D010663:Phenylmercury Compounds