Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations
Mercury is a highly toxic heavy metal that may cause neurological, respiratory, gastrointestinal and dermatological illnesses. Previously described neurological manifestations of mercury toxicity are symmetrical, and include a pancerebellar syndrome, generalised seizures and encephalopathy. Mer...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
South African Medical Association
2023-12-01
|
| Series: | South African Medical Journal |
| Subjects: | |
| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1127 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860528224665600 |
|---|---|
| author | J George E Sadiq I Moola S Maharaj A Mochan |
| author_facet | J George E Sadiq I Moola S Maharaj A Mochan |
| author_sort | J George |
| collection | DOAJ |
| description |
Mercury is a highly toxic heavy metal that may cause neurological, respiratory, gastrointestinal and dermatological illnesses. Previously described neurological manifestations of mercury toxicity are symmetrical, and include a pancerebellar syndrome, generalised seizures and encephalopathy. Mercury is used in the gold mining process, and in artisanal or illicit gold mining, often without necessary protection. Here we describe the cases of two artisanal gold miners from western Johannesburg, South Africa, who presented with atypical neurological manifestations of mercury toxicity. Patient 1 presented with focal seizures, an asymmetrical cerebellar syndrome and an acute encephalopathy. Patient 2 had unilateral cerebellar ataxia. Both patients had toxic mercury levels, with no other cause identified for their symptoms. Patient 1 responded well to chelation therapy, but patient 2 refused admission and further medical treatment. The neurological manifestations of mercury toxicity are typically symmetrical, whereas our two patients presented with markedly asymmetrical features. It is important to maintain a high index of suspicion for mercury poisoning, even in patients with atypical and unilateral or asymmetrical presentations. A prompt diagnosis and the commencement of early chelation therapy have the potential to produce good outcomes.
|
| format | Article |
| id | doaj-art-c7b2f8aac2f9488c879f171de28c7c4c |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-c7b2f8aac2f9488c879f171de28c7c4c2025-02-10T12:26:36ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352023-12-011131210.7196/SAMJ.2023.v113i12.1127Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentationsJ George0E Sadiq1I Moola2S Maharaj3A Mochan4 Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaDivision of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Mercury is a highly toxic heavy metal that may cause neurological, respiratory, gastrointestinal and dermatological illnesses. Previously described neurological manifestations of mercury toxicity are symmetrical, and include a pancerebellar syndrome, generalised seizures and encephalopathy. Mercury is used in the gold mining process, and in artisanal or illicit gold mining, often without necessary protection. Here we describe the cases of two artisanal gold miners from western Johannesburg, South Africa, who presented with atypical neurological manifestations of mercury toxicity. Patient 1 presented with focal seizures, an asymmetrical cerebellar syndrome and an acute encephalopathy. Patient 2 had unilateral cerebellar ataxia. Both patients had toxic mercury levels, with no other cause identified for their symptoms. Patient 1 responded well to chelation therapy, but patient 2 refused admission and further medical treatment. The neurological manifestations of mercury toxicity are typically symmetrical, whereas our two patients presented with markedly asymmetrical features. It is important to maintain a high index of suspicion for mercury poisoning, even in patients with atypical and unilateral or asymmetrical presentations. A prompt diagnosis and the commencement of early chelation therapy have the potential to produce good outcomes. https://samajournals.co.za/index.php/samj/article/view/1127MercuryToxicityMinersInformalNeurologyAtaxia |
| spellingShingle | J George E Sadiq I Moola S Maharaj A Mochan Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations South African Medical Journal Mercury Toxicity Miners Informal Neurology Ataxia |
| title | Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations |
| title_full | Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations |
| title_fullStr | Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations |
| title_full_unstemmed | Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations |
| title_short | Informal gold miners with mercury toxicity: Novel asymmetrical neurological presentations |
| title_sort | informal gold miners with mercury toxicity novel asymmetrical neurological presentations |
| topic | Mercury Toxicity Miners Informal Neurology Ataxia |
| url | https://samajournals.co.za/index.php/samj/article/view/1127 |
| work_keys_str_mv | AT jgeorge informalgoldminerswithmercurytoxicitynovelasymmetricalneurologicalpresentations AT esadiq informalgoldminerswithmercurytoxicitynovelasymmetricalneurologicalpresentations AT imoola informalgoldminerswithmercurytoxicitynovelasymmetricalneurologicalpresentations AT smaharaj informalgoldminerswithmercurytoxicitynovelasymmetricalneurologicalpresentations AT amochan informalgoldminerswithmercurytoxicitynovelasymmetricalneurologicalpresentations |