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A sentinel health event (occupational) associated with carbon monoxide poisoning and chronic exposure to manganese fume or dust; [Mullan] Case control studies have suggested a relationship between Parkinson's disease and exposure to carbon disulfide, but the more commonly seen syndrome following chronic carbon disulfide exposure is peripheral neuropathy, fatigue, headache, and insomnia. [LaDou, p. 378] Delayed-onset Parkinsonism has occurred after severe cyanide poisoning. [ATSDR Case Studies # 15] Parkinson's disease is an idiopathic, slowly progressive, degenerative CNS disorder with 3 characteristic features: resting tremor, muscular rigidity, and slowness and poverty of movement (bradykinesis). In Parkinsonism caused by drugs and toxins, the tremor is usually less prominent. [Harrison's Practice] Parkinsonism caused by manganese has the following that distinguish it from Parkinson's disease: psychiatric symptoms early in the disease; cock walk; tendency to fall backward; less frequent resting tremor; more frequent dystonia; lack of response to dopaminomimetics; abnormal MRI showing manganese in the pallidum and caudate nucleus; and normal fluorodopa positron emission tomography scan. [IRRST] |
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