Neuropsychiatric Manifestations of Chronic Manganese Poisoning.

Clinical manifestations appearing in labourers working with manganese in various industrial fields were discovered about 125 years ago. Couper in 1837 was the first to report the appearance of a peculiar neurological picture similar to Parkinson's shaking palsy in five men grinding manganese dioxide in France. Forty-two years later, Schlockow (1879) reported another 42 cases. In addition von Jaksch from 1901 to 1907 reported another 15 cases. Though he was the first to describe the peculiar 'cock walk' gait, yet he diagnosed them as having a disease similar to disseminated sclerosis. It was not until 1919 that the definite relation between the epidemiological, clinical, and pathological or toxic effects ofmanganese poisoning on the central nervous system was established by Edsall, Wilbur, and Drinker (1919). Their review drew attention to the serious effects on the central nervous system of this occupational disease. Subsequently a large number of cases have been reported from many countries. The first few cases in Egypt were described by Baader in 1932, and a few years later, in 1936, 26 cases were reported by Nazif and 11 cases by Scander and Sallam. Abd El Naby and Hassanein (1963), surveying chronic manganese intoxication from the industrial and hygienic points of view, commented on 32 cases with neuropsychiatric manifestations secondary to exposure to manganese ore in the mines. In this paper, another survey was done in which 13 further cases were added to the previous group, with the aim of studying and analysing the various clinical neuropsychiatric presentations of chronic manganese poisoning among Egyptians.