Levodopa failure in chronic manganism

  title={Levodopa failure in chronic manganism},
  author={C. S. Lu and C. -C. Huang and N. S. Chu and Donald B. Calne},
  pages={1600 - 1600}
We report a placebo-controlled study of levodopa in four patients with extrapyramidal deficits caused by chronic manganese intoxication. Their parkinsonism and dystonia had progressed slowly over a period of 5 years after they left the site of exposure. Initially the patients appeared to respond to levodopa in open observations, but this apparent benefit was not sustained. This short-term, double-blind study indicates that their parkinsonism and dystonia failed to respond to levodopa. 
The natural history of neurological manganism over 18 years.
Manganism and idiopathic parkinsonism
There are similarities between PD and manganism, notably the presence of generalized bradykinesia and widespread rigidity and the following dissimilarities in manganistan: (a) less-frequent resting tremor, (b) more frequent dystonia, and (c) a particular propensity to fall backward.
Long-term progression in chronic manganism
The data indicate that clinical progression in patients with manganese parkinsonism continues even 10 years after cessation of exposure, and the deterioration was most prominent in gait, rigidity, speed of foot tapping, and writing.
Effect of levodopa treatment for parkinsonism in welders
L-Dopa therapy is not effective for the management of parkinsonism in welders and l-dopa unresponsiveness may be useful to distinguish manganese-induced parkinsonic syndrome from Parkinson disease.
Parkinsonism induced by chronic manganese intoxication--an experience in Taiwan.
After long-term follow-up studies, patients with manganism showed prominent deterioration in the parkinsonian symptoms during the initial 5-10 years, followed by a plateau during the following 10 years, which is different from the clinical course of patients with PD.
Original footage of the Chilean miners with manganism published in Neurology in 1967
Manganism has captured the imagination of neurologists for more than a century because of its similarities to Parkinson disease and its indirect but seminal role in the “l-dopa miracle.” We present
Manganic encephalopathy due to “ephedrone” abuse
The clinical and neuroimaging features of 6 drug‐abuse patients with self‐inflicted manganese poisoning are described, consisting of apathy, bradykinesia, gait disorder with postural instability, and spastic‐hypokinetic dysarthria.
Presynaptic and postsynaptic striatal dopaminergic function in patients with manganese intoxication
It is concluded that nigrostriatal dopaminergic dysfunction is not responsible for the parkinsonism caused by chronic Mn intoxication, and the pathology is likely to be downstream of the dopaminaergic projection.
Parkinsonism due to Manganism in a Welder
This patient emphasizes the importance of a careful occupational history in persons presenting with atypical manifestations of a neurodegenerative disorder and lends support to the hypothesis that welding can produce enough exposure to manganese to produce neurologic impairment.
Parkinsonism and dystonia caused by the illicit use of ephedrone—A longitudinal study
A neurological syndrome characterized by levodopa unresponsive bradykinesia, retropulsion with falls backwards, dysarthria, gait disturbance, dystonia, and emotional lability was identified in 13


Chronic manganism. Neurologic and laboratory studies during treatment with levodopa.
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.
Progression after chronic manganese exposure
It is concluded that patients with manganese-induced parkinsonism may develop increasing neurologic dysfunction long after cessation of exposure and that their responses to levodopa are different from those of patients with Parkinson's disease.
Chronic manganese intoxication.
It is indicated that, in the absence of rigidity or dystonia or both, levodopa is ineffective in chronic manganese intoxication.
Modification of chronic manganese poisoning. Treatment with L-dopa or 5-OH tryptophane.
Six patients with hypokinetic forms of chronic manganese poisoning received slowly increasing oral doses of L-dopa up to 8.0 gm per day distributed through the day showed striking reduction or disappearance of rigidity and of hypokinesia, marked improvement of postural reflexes and restitution of balance, and two patients with severe dystonia from chronic mangansese poisoning were markedly improved by L- dopa.
Chronic manganese poisoning
Arguments in favor of the thesis that chronic manganese poisoning may diverge significantly from the aforementioned diseases are developed.
Manganese induced parkinsonism: an outbreak due to an unrepaired ventilation control system in a ferromanganese smelter.
It is concluded that the outbreak resulted from exposure to high concentrations of manganese fumes through the breakdown of the ventilation system.
Investigation of the validity of Halstead's measures of biological intelligence.
  • R. Reitan
  • Psychology
    A.M.A. archives of neurology and psychiatry
  • 1955
The whole theory of learning and intelligence is in confusion. We know at present nothing of the organic basis of these functions and little enough of either the variety or uniformities of their