Manganese madness

In workers with chronic inhalation exposure, iron deficiency and liver cirrhosis are commonly observed. Chronic inhalation exposure also affects the CNS, resulting in Parkinsonian-like symptoms. Mental aberrations are also observed. The psychiatric disturbance has been called manganese madness . Symptoms include confusion, unusual behavior, and sometimes hallucinations. Apathy, difficulty with speech, and loss of balance are most common. Other symptoms include difficulty with fine motor movement, anxiety, and pain. Manganese intoxication can result in a syndrome of parkinsonism and dystonia. If these extrapyramidal findings are present, they are likely to be irreversible... 

In serious cases, virtually all the symptoms in Table 9-3 appear, especially uncontrollable laughter or crying, mood disturbances, cognitive and perceptual abnormalities, sleep disturbances, and impulsive or silly acts. These symptoms constitute the classic description of manganese madness. Psychiatric symptoms usually precede neurological symptoms, although neurological symptoms... 

The relationship between lowered body levels of manganese (and zinc) and schizophrenia was discussed completely by Pfeiffer and Bacchi in 1975 [72], and was covered more recently by Donaldson [64]. A clinical condition termed locura manganica (manganese madness) has been described in Chilean manganese miners who have suffered acute manganese aerosol intoxication. This psychotic behavior is reminiscent of symptoms of schizophrenia, and Donaldson proposes that the cause is again manganese interaction with dopamine in the central nervous system. 

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