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Manganese is an essential trace mineral that has a vital role in maintaining various body functions. Manganese toxicity, referred to as Manganism, causing parkinsonism is a well-known phenomenon that occurs secondary to chronic environmental and occupational exposure to manganese. Patients with underlying chronic liver disease are also susceptible to the toxic accumulation of manganese since it essentially undergoes biliary excretion.

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Article Synopsis
  • Focal imaging abnormalities in parkinsonism patients indicate a secondary cause, necessitating a unique diagnostic and treatment approach.
  • Various factors such as vascular issues, brain injuries, and toxic exposures can lead to secondary parkinsonism, presenting with symptoms like rigidity and bradykinesia, often without rest tremor.
  • Neuroimaging, especially MRI, is vital for diagnosis, as recognizing imaging abnormalities in context can lead to effective treatment; many secondary forms are reversible, improving our understanding of Parkinson's disease and brain function.
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Acquired chronic hepatocerebral degeneration (CAHD) is a rare and irreversible neurological disorder that can occur in patients with chronic liver disease. It is characterized by neurological symptoms similar to parkinsonism and the presence of brain damage secondary to manganese deposition. We present the case of a 60-year-old patient with episodes of recurrent hepatic encephalopathy and diagnosis of CAHD.

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