Diagnosis of Chronic Manganese Intoxication by Magnetic Resonance Imaging

To the Editor: Manganese intoxication is a well-known cause of parkinsonism and dementia. It affects miners, welders, steelworkers, pyrotechnists, and workers in other occupations. The diagnostic hallmarks are occupational exposure, a compatible clinical syndrome, and high levels of manganese in blood or urine.1 Recently, magnetic resonance imaging (MRI) has been reported to be useful in the diagnosis of manganese intoxication.2 We describe a case of manganese encephalopathy that began with a drop attack and that was diagnosed with cranial MRI. A 54-year-old building worker who was frequently in contact with welders reported having sudden unprovoked falls without loss of consciousness . . .