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Cerebellar ataxia due to lead encephalopathy in an adult
  1. Department of Neurology, KEM Hospital, Parel, Mumbai 400012, India
  1. Dr J Mani, Department of Neurology, Ward 10, KEM Hospital, Parel Mumbai 400012, India.

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Lead has been used by humans as long as recorded history for various purposes ranging from jewellery to weapons and construction materials, paints, and pigment manufacture. Lead colic was known to ancient physicians since the time of Hippocrates, but encephalopathy was first described as late as 1925; it is especially common in children. Here we report a rare case of lead encephalopathy associated with ataxia in a 30 year old battery plate manufacturer.

T2 weighted MRI showing hyperintensities in both thalami.

He had been working for the past 12 years in a factory making battery plates. He presented with history of abnormal behaviour and unsteadiness of gait for 8 days accompanied by colicky abdominal pain and paraesthesiae in the legs. Later the patient started behaving abnormally; he shouted irrelevantly, became violent, and refused to recognise relatives. He was treated with antipsychotic medication which quietened him. Two days later he had difficulty in walking. His gait was unsteady and speech was incoherent.

Enquiry disclosed two earlier episodes of abdominal pain with abnormal behaviour in the past year which responded to treatment, the details of which were not available. Two other factory workers had also had episodic abnormal behaviour but were not available for interrogation. There was no history of fever or symptoms suggestive of raised intracranial pressure, …

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