The effect of manganese on the central nervous system. On the basis of ten cases with hyperintensities in the globus pallidus and a part of the brainstem on T1-weighted magnetic resonance imaging

We examined the effect of manganese (Mn) on the central nervous system, on the basis of ten cases with hyperintensities in the globus pallidus and a part of the brainstem on T1-weighted magnetic resonance imaging (MRI). These cases were divided into three groups; four cases with liver dysfunction, three cases with intravenous infusion containing Mn and three cases without any specific factor. Mn levels were measured in serum, whole blood and cerebrospinal fluid (CSF). As a result, their serum and CSF Mn levels were significantly higher (P<0.05 and P<0.01, respectively) than those of the control subjects, while their whole blood Mn levels were not significantly different. Single photon emission computed tomography demonstrated a decrease of the cerebral blood flow in the frontal lobe in four cases with the hyperintensities and in one of them the decrease improved after the disappearance of the hyperintensity. Oculogyric crisis in one case with intravenous infusion containing Mn and dystonia in one case without any specific factor also improved, when the hyperintensities disappeared. In the cases with T1-weighted MRI hyperintensities, it is important to measure serum and CSF Mn levels as well as to observe psychiatric and neurological symptoms. (author)