A BSTRACT Mercury is a well-established neurotoxin that can lead to progressive neurological deterioration, including Parkinsonian disorder. This is a case report of a 60-year-old man with a history of long-term occupational exposure to mercury, having worked in a battery and treadmill material manufacturing company for several decades. Over a year, he developed progressive gait abnormalities, asymmetric rigidity, postural tremors, bradykinesia, speech tremors, hypomimia, and frequent falls resembling atypical Parkinsonism. Magnetic resonance imaging (MRI) of the brain revealed diffuse cerebral atrophy. Initial qualitative screening analysis of the urine sample was suggestive of mercury intoxication, prompting further clinical toxicological analysis. Inductively coupled plasma mass spectrometry (ICP-MS) confirmed elevated mercury levels in blood, hair, and nail samples. The exclusion of other neurodegenerative disorders and the strong temporal association with chronic mercury exposure supported a diagnosis of rapidly progressive Parkinsonism due to mercury toxicity. This case underscores the critical role of clinical analytical toxicology in identifying heavy metal-induced neurological disorders. Early detection through neuroimaging and toxicological screening is vital for accurate diagnosis. The findings highlight the necessity of workplace safety regulations, public health interventions, and legal frameworks to mitigate occupational mercury exposure risks. Integrating forensic and clinical approaches enhances diagnostic accuracy, differentiates toxin-induced Parkinsonism from idiopathic neurodegenerative conditions, and is informative for medical, legal, and occupational health policies.
Jain et al. (Wed,) studied this question.