title: Manganese intoxication: the cause of an inexplicable epileptic syndrome in a 3 year old child.
abstract: Excess manganese (Mn) can cause several neurotoxic effects, however only a few studies have reported epileptic syndromes related to manganese intoxication. We describe an epileptic syndrome due to manganese intoxication in a 3 year old male child. His blood manganese was elevated, but no other abnormal values or toxic substances were found in blood or urine. The electroencephalogram (EEG) showed a picture of progressive encephalopathy, while brain magnetic resonance was normal. The patient's conditions rapidly worsened to epileptic status despite the use of antiepileptic drugs. Chelating treatment with CaNa(2)EDTA was initiated to remove excess manganese and promptly succeeded in reverting epileptic symptoms. Concurrently, manganese blood levels and electroencephalogram progressively normalized. Thereafter it has been possible to discontinue antiepileptic treatment, and the patient remains in excellent conditions without any treatment.
authors.affiliation: Department of Traumatology, Orthopaedics and Occupational Health, Neurotoxicology Unit, CTO Hospital, University of Turin, Turin, Italy. elena.herrero@unito.it
authors.forename: Elena
authors.initials: E
authors.lastname: Herrero Hernandez
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Discalzi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Dassi
authors.forename: Laura
authors.initials: L
authors.lastname: Jarre
authors.forename: Enrico
authors.initials: E
authors.lastname: Pira
mesh_terms: D002614:Chelating Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000097:blood* / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008345:Manganese / Q000009:adverse effects* / Q000097:blood* / Q000652:urine; D020149:Manganese Poisoning / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D013577:Syndrome
chemical_list: D002614:Chelating Agents; D008345:Manganese