Movement Disorders and Dementia in a Woman With Chronic Aluminium Toxicity: Video-MRI Imaging

Antonio Jose Reyes; Kanterpersad Ramcharan; Stanley Lawrence Giddings; Amrit Ramesar; Edmundo Rivero Arias; Fidel Rampersad

doi:10.5334/tohm.588

Movement Disorders and Dementia in a Woman With Chronic Aluminium Toxicity: Video-MRI Imaging

Tremor Other Hyperkinet Mov (N Y). 2021 Feb 1:11:5. doi: 10.5334/tohm.588.

Authors

Antonio Jose Reyes¹, Kanterpersad Ramcharan², Stanley Lawrence Giddings³, Amrit Ramesar¹, Edmundo Rivero Arias¹, Fidel Rampersad⁴

Affiliations

¹ Neurology Unit; Department of Medicine, San Fernando Teaching Hospital, The University of the West Indies, TT.
² Department of Medicine, Surgi-Med Clinic, San Fernando, TT.
³ Department of Medicine, San Fernando Teaching Hospital, The University of the West Indies, TT.
⁴ Radiology Department, The University of the West Indies, St. Augustine, TT.

Abstract

Background: Aluminium encephalopathy results from exposure to aluminium from occupational, recreational, and environmental sources. Movement disorders, cerebellar ataxia, pyramidal tract signs, dementia, microcytic anemia and bone disease are typical manifestations.

Case report: A 55-year-old woman had clinical manifestations, persistent hyperaluminemia without magnetic resonance imaging (MRI) scan changes of toxic encephalopathy following a prolonged exposure to marine grade paints containing 30% aluminium. Chelation therapy with ethylenediaminetetraacetic acid (EDTA) demonstrated decreased levels of aluminemia and significant neurological improvement over time.

Discussion: This diagnosis should be entertained in patients with movement disorders, cerebellar ataxia, pyramidal signs, and dementia of unknown etiology.

Highlights: Aluminium encephalopathy (AE) is a neurological syndrome caused by aluminium neurotoxicity. Manifestations include cognitive impairment, motor dysfunction, microcytic anemia and bone disease. This case illustrates AE with hyperaluminemia associated with chronic exposure to industrial paints and clinical and biochemical reversibility after chelation therapy with ethylenediaminetetraacetic acid. Movement disorders are highlighted.

Keywords: Encephalopathy; aluminium; dementia; movement disorders; paints.

Publication types

Case Reports

MeSH terms

Aluminum / toxicity
Brain Diseases*
Dementia* / chemically induced
Dementia* / diagnostic imaging
Dementia* / drug therapy
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Movement Disorders* / diagnostic imaging
Movement Disorders* / etiology

Substances

Aluminum