Metals and movement disorders

Purpose of reviewRecent advances in genetics, diagnosis, and management of disorders associated with brain manganese, copper, and iron brain accumulation are reviewed.Recent findingsA genetic disorder leading to manganese accumulation in children and young adults has recently been identified and may be treated successfully with chelation. Neurodegeneration of the basal ganglia in chronic acquired hepatocerebral syndrome and ephedrone toxicity has been linked with acquired manganism. New mutations in genes linked with accumulation of iron and copper in the brain have also been identified.SummaryRecent genetic findings have shed light on the role of iron, manganese, and copper in neurodegenerative disease. MRI is a helpful diagnostic tool in the investigation of basal ganglia disease when iron accumulation is suspected. Chelation therapy is effective for Wilson's disease and hereditary hypermanganesemia, but there is no proven effective treatment for toxic manganese exposure.