A Child with Elemental Mercury Poisoning and Unusual Brain MRI Findings

Abstract

Mercury vapor poisoning is a serious and potentially fatal problem. Neurological manifestations involving the central nervous system are seen with chronic mercury intoxication. We present the case of a 10-year-old child who demonstrated acrodynia, seizures, and visual impairment following 20 days of exposure to elemental mercury at home. The initial blood mercury concentration was 27.7 µg/L (normal <2 µg/L) and the initial 24-hour urine mercury concentration was 34.4 µg/L (normal =10 µg/L). After 9 months of treatment with D-penicillamine, the patient's clinical condition, biochemical laboratory parameters, and mercury concentrations all returned to normal. The T2-weighted MRI images of the patient's brain initially showed multiple hyperintense lesions in cerebral white matter, left globus pallidus, and putamen, which also improved.

Keywords :

• Mercury poisoning
• Brain MRI
• Acrodynia