The neuropsychiatric sequelae of mercury poisoning. The Mad Hatter's disease revisited

O'Carroll, R. E.; Masterton, G.; Dougall, N.; Ebmeier, K. P.; Goodwin, G. M.

Abstract

BACKGROUND The detailed effects of mercury poisoning on cognitive function, brain anatomy and regional brain function are largely unknown. We report the case of a 38-year-old man who was exposed to toxic levels of inorganic mercury.

METHOD Four years after exposure, the patient was assessed using magnetic resonance imaging (MRI), single-photon emission computerised tomography (SPECT) and detailed neuropsychological evaluation.

RESULTS The patient developed a myriad of physical and psychiatric complaints, including stomatitis, muscle spasm, tremor, skin rash and the psychiatric syndrome known as 'erythism' (Mad Hatter's disease). Neuropsychological evaluation revealed marked and significant deficits of attention concentration, particularly when under time pressure. The MRI scan was unremarkable; however, SPECT revealed hypermetabolism of the posterior cingulate

CONCLUSIONS Mercury poisoning appeared to result in a dysregulation of posterior cingulate cortex, which was associated with attention/concentration deficits and marked anxiety/agitation.

• Journal Article Type: Article
• Acceptance Date: Jan 1, 1995
• Online Publication Date: Jan 2, 2018
• Publication Date: Jul 1, 1995
• Deposit Date: Sep 30, 2016
• Journal: The British Journal of Psychiatry
• Print ISSN: 0007-1250
• Electronic ISSN: 1472-1465
• Publisher: Royal College of Psychiatrists
• Peer Reviewed: Peer Reviewed
• Volume: 167
• Issue: 1
• Pages: 95-98
• DOI: https://doi.org/10.1192/bjp.167.1.95
• Keywords: brain function, mercury poisoning, attention/concentration deficits,
• Public URL: http://researchrepository.napier.ac.uk/Output/396451