Toxic encephalopathy due to mercury: A rare case report and literature review.

RATIONALE: Mercury toxic encephalopathy is uncommonly encountered in clinical practice.

PATIENT CONCERNS: The aim of presenting this case is to increase the awareness of this disease, especially regarding its radiological presentation.

DIAGNOSES: Toxic encephalopathy due to mercury.

INTERVENTIONS: The medical team administered sodium dimercaptopropane sulfonate as a mercury antagonist and treated with plasma purification and massive hydration to promote mercury excretion.

OUTCOMES: Following admission, the patient underwent an magnetic resonance imaging (MRI) examination. The results revealed symmetrical alterations in the brain parenchyma (including both cerebrum and cerebellum), characterized by hypoperfusion on MRI perfusion imaging. The patient died after a series of lifesaving measures.

LESSONS: Mercury poisoning encephalopathy is a rare disorder for which currently established diagnostic criteria are lacking. On brain MRI scans, it manifests as symmetric cerebral edema, involving the parenchyma of both the cerebrum and cerebellum. It is important to question patients carefully about any history of exposure to mercury-containing drugs.