Manganism or Manganese Poisoning Leads to Parkinson–like Symptoms

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What is

Prolonged exposure to manganese may lead to manganese poisoning, a condition known as manganism. You should be concerned about this disease if you are a welder because you may have been exposed to high levels of manganese through welding rod fumes, which contain various toxic metals. (See Manganese in Welding Fumes).

Manganism looks similar to Parkinson’s disease. Patients with either disease exhibit a fixed gaze, tremors, body rigidness, and slowed movement (bradykinesia). Welders exposed to manganese are more likely to develop Parkinson’s disease than the rest of the population, especially at an early age.

Clinical Stages of Manganese Poisoning

Doctors recognize three stages of manganism or manganese poisoning (Int J Occup Environ Health. 2003 Apr–Jun; 9(2): 153–63). In the first stage, patients are exhausted, apathetic, and weak, and may get headaches. The patient’s problems may easily be confused with depression and other illnesses. Some researchers believe that this early stage is reversible. If you are a welder who has been experiencing these early symptoms, you should remove yourself from the source of manganese exposure.

The second stage involves short–term memory loss, impaired judgment, slurred speech, and sometimes even hallucinations. “Manganese madness” was the term used to describe the compulsive, strange behavior of workers in the manganese mines (J Toxicol Clin Toxicol. 1999; 37(2): 293–307).

Signs of the last stage include involuntary muscle movements; tremors; poor coordination; a mask–like, rigid face; and a staggering, strutting gait. This final stage is irreversible and may lead to complete disability. Removing a patient from manganese exposure at this point does not seem to be helpful. In one study, the disease progressed over a 10–year period even after patients were no longer exposed to manganese (Neurology. 1998 Mar; 50(3): 698–700).

The symptoms of manganism may appear anywhere from several months to several years after a patient’s initial contact with manganese (Int J Toxicol. 2003 Sep–Oct;22(5):393–401). If you have been exposed to manganese, it is important to have regular medical checkups and to let your doctor know about your work history. See Diagnosing Manganism for further details.