Chronic Manganism:  Neurologic and Laboratory Studies During Treatment With Levodopa

Harvey A. Rosenstock, MD; David G. Simons, MD; John Stirling Meyer, MD
JAMA. 1971;217(10):1354-1358. doi:10.1001/jama.1971.03190100038007.
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A case of chronic manganese intoxication emphasizes that the disorder, while uncommon, is not rare, and that the psychiatrist as well as the neurologist may be the first physician consulted. Diagnostic evaluations included urine assays for manganese following edetic acid infusion and analyses of scalp and chest hair. The analysis for chest hair manganese is thought to be reported for the first time. The concentration of manganese in chest hair was more than three times the concentration in scalp hair. Clinical experience with a four-month therapeutic trial of levodopa converted abnormal reflex patterns to normal, improved mentation and speech, and reduced dysdiadochokinesia and bradykinesia. Dystonia was not improved.


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