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Chronic Manganese Toxicity Associated with Voltage-Gated Potassium Channel Complex Antibodies in a Relapsing Neuropsychiatric Disorder

Author

Listed:
  • Cyrus S.H. Ho

    (Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore)

  • Roger C.M. Ho

    (Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore)

  • Amy M.L. Quek

    (Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
    Division of Neurology, University Medicine Cluster, National University Hospital, Singapore 119074, Singapore)

Abstract

Heavy metal poisoning is a rare but important cause of encephalopathy. Manganese (Mn) toxicity is especially rare in the modern world, and clinicians’ lack of recognition of its neuropsychiatric manifestations can lead to misdiagnosis and mismanagement. We describe the case of a man who presented with recurrent episodes of confusion, psychosis, dystonic limb movement and cognitive impairment and was initially diagnosed with anti-voltage-gated potassium channel (VGKC) complex limbic encephalitis in view of previous positive autoantibodies. His failure to respond to immunotherapy prompted testing for heavy metal poisoning, which was positive for Mn. This is the first report to examine an association between Mn and VGKC antibodies and the effects of Mn on functional brain activity using functional near-infrared spectroscopy (fNIRS).

Suggested Citation

  • Cyrus S.H. Ho & Roger C.M. Ho & Amy M.L. Quek, 2018. "Chronic Manganese Toxicity Associated with Voltage-Gated Potassium Channel Complex Antibodies in a Relapsing Neuropsychiatric Disorder," IJERPH, MDPI, vol. 15(4), pages 1-8, April.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:783-:d:141684
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    References listed on IDEAS

    as
    1. Gunnar F. Kwakye & Monica M.B. Paoliello & Somshuvra Mukhopadhyay & Aaron B. Bowman & Michael Aschner, 2015. "Manganese-Induced Parkinsonism and Parkinson’s Disease: Shared and Distinguishable Features," IJERPH, MDPI, vol. 12(7), pages 1-22, July.
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