Idiopathic parkinsonism with superimposed manganese exposure: utility of positron emission tomography.
It is difficult to distinguish manganism from idiopathic parkinsonism by clinical signs only. Case history and examination: A 48-year-old welder for over 10 years complained of masked face, right side (arm and leg) resting tremor, and bradykinesia for over one year. Magnetic resonance imaging (MRI) findings showed symmetrical high signal intensities in the globus pallidus on T1 weighted image. These intensities disappeared almost completely six months after cessation of exposure. 18F-6-fluorodopa (18F-dopa) positron emission tomography (PET) findings showed reduced 18F-dopa uptake in the left putamen, findings which appear in idiopathic parkinsonism. A PET study is necessary to distinguish manganism from idiopathic parkinsonism, especially in a working environment with elevated Mn concentrations, such as welding.
Kim
Y
Y
Industrial Health Research Institute, Korea Industrial Safety Corporation (KISCO), Incheon, South Korea. yanghokm@nuri.net
Kim
J W
JW
Ito
K
K
Lim
H S
HS
Cheong
H K
HK
Kim
J Y
JY
Shin
Y C
YC
Kim
K S
KS
Moon
Y
Y
D003937:Diagnosis, Differential; D004295:Dihydroxyphenylalanine / Q000493:pharmacokinetics*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020149:Manganese Poisoning; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010300:Parkinson Disease / Q000175:diagnosis*; D011699:Putamen / Q000378:metabolism*; D014055:Tomography, Emission-Computed / Q000379:methods
D004295:Dihydroxyphenylalanine