Elevated manganese levels associated with dementia and extrapyramidal signs.
In a patient with elevated manganese levels, dementia, and an extrapyramidal syndrome, brain biopsy showed numerous neuritic plaques and neurofibrillary tangles typical of Alzheimer's disease. Manganese was elevated beyond toxic levels in serum, hair, urine, feces, and brain. The possible relationship of elevated manganese levels, dementia, and the extrapyramidal syndrome warrants further studies of similar cases.