Abstract
Occupational exposure to manganese can cause parkinsonism. Recent reports suggest that manganese toxicity can occur as a result of exposure to welding fumes; welding has been proposed as a risk factor for Parkinson disease (PD). Joseph Jankovic examines the evidence for and against a relationship between welding, manganese, parkinsonism, and PD. see page 2021 Josephs et al. report eight welders working with inadequate ventilation, presenting with varied neurologic syndromes and pallidal MRI T1 hyperintensity, a biomarker of brain manganese accumulation. The syndromes included atypical parkinsonism, multifocal myoclonus plus mild cognitive impairment, vestibular-auditory dysfunction with truncal ataxia, and isolated mild cognitive impairment. ![][1] Figure. High T1 signal change in the globus pallidus in manganese toxicity from occupational exposure (welding). see page 2033 The editorial by Karl Kieburtz and Roger Kurlan notes that since genetic causes appear identifiable in a minority of PD cases, there has been an extensive search for environmental causes. Two earlier articles in Neurology by Racette et al. described a potential relationship between welding and PD. Manganese, one of the metals found in welding fume, is a neurotoxicant and can lead to a neurologic syndrome with parkinsonian features, which has led to speculation that manganese … [1]: /embed/graphic-1.gif
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