A case of developmental exposure to inorganic mercury

This case report describes behavioral and neuropsychological function in a young man who experienced chronic exposure to elemental mercury at home from age 4 through 9 years. Data are presented on school history, behavior, and performance on standardized tests during the developmental period, and from a full neuropsychological evaluation at age 19 years, several years after environmental exposure had ended. These data specify the course of a decline in function as development proceeds. The patient's progress appeared normal in the preschool period but pronounced academic difficulties and persistent emotional irritability emerged during the elementary school years. At age 19 years, neuropsychological testing revealed diminished executive function, difficulties with language, problems with visuospatial orientation, deficiencies in tine motor control, and manual tremor. Tension, irritability, and depressive affect were evident as well as marked problems with academic performance. These findings suggest widespread cerebral dysfunction, both cortical and subcortical, and are consistent with the diffuse pattern of brain damage seen in children with exposure to heavy metals.