| 망간중독에 의한 파킨슨 증후군 3례
-파킨슨병과의 감별점을 중심으로- |
| 김재우, 김양호*, 정해관**, 이애영***, Kengo Ito**** |
| 동아대학교 의과대학 신경과학교실, 산업보건연구원*, 동국대학교 의과대학 예방의학교실**, 충남대학교 의과대학 신경과학교실***, 일본 장수의료연구센터**** |
| Three Cases of Manganese Induced Parkinsonism
-Differences from Idiopathic Parkinsonism- |
| Jae-Woo Kim, M.D., Yangho Kim, M.D.*,
Hae-Kwan Cheong, M.D.**, Ae-Young Lee, M.D.***, Kengo Ito, M.D.**** |
| Department of Neurology, Dong-A University College of Medicine, Industrial Health Research Institute*, Preventive Medicine, Dongguk University **, Neurology, Chungnam National University ***, National Institute for Longevity Science, Japan**** |
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| Abstract |
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Manganese (Mn) intoxication is known to induce parkinsonism. Mn-induced parkinsonism preferentially affects the globus pallidus in contrast to idiopathic parkinsonism where the degeneration predominantly involves the nigral pars compacta. We present three patients who had been occupationally exposed to Mn and developed parkinsonism, and one patient who had been exposed to long-term Mn and was proven to have idiopathic parkinsonism. All the manganism patients had a particular propensity to fall in a backward gait and a prominent postural instability compared with the severity of other parkinsonian features. Case 1 also showed a cock walk and dystonic features, quite characteristic findings of manganism. The rigidity, another important parkinsonian sign, was not found in all three manganism patients. There was no sustained therapeutic response to levodopa. A [18F]6-fluoro-L-dopa (6FD) PET scan performed in case 1 was normal in contrast to a reduced uptake in the striatum of the patient with idiopathic parkinsonism. These cases indicate that Mn-induced parkinsonism can be differentiated from idiopathic parkinsonism in that the former has unique clinical features and a normal 6FD PET scan.
Key words : manganese, parkinsonism, PET |
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