Portal-systemic encephalopathy with hypermanganesemia: A case report and review of the literature

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome of patients with chronic liver disease. In addition to ammonia levels, increased manganese levels in the brain are also considered as having role in the pathogenesis of HE. On cranial T1-weighted magnetic resonance imaging (MRI), hyperintense and symmetrical globus pallidi linked to the manganese deposition are characteristic for patients with cirrhosis of the liver. We presented here a case of portal-systemic encephalopathy demonstrated with typical MR images and increased blood manganese concentra-tion.