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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(09): s00451811622
DOI: 10.1055/s-0045-1811622
Review Article

A Brazilian Minamata disease? Neurologists must be aware of mercury exposure and intoxication

Gustavo Maximiano-Alves 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
,
Eder Leandro da Silva Dantas 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
,
Maria Elena Crespo-Lopez 
2   Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém PR, Brazil.
3   Instituto Amazônico do Mercúrio, Belém PA, Brazil.
,
José Luiz Martins do Nascimento 
2   Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém PR, Brazil.
4   Instituto Nacional de Ciências e Tecnologia em Neuroimunologia, Rio de Janeiro RJ, Brazil.
› Author Affiliations
Funding Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), grant numbers 313406/2021-9, and 406442/2022-3. Fundação Amazônia de Amparo a Estudos e Pesquisas (FAPESPA), grant number 040/2023. Brazilian Ministry of Justice and Public Security, Termo de Execução Descentralizada n° 08/2023 (26068571).
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Abstract

Mercury intoxication poses a significant challenge and growing threat to public health, particularly in the Amazon region. Despite a known history of neurological damage, as evidenced by Japan's Minamata disease, mercury intoxication remains underdiagnosed in Brazil. This review underscores the need for increased clinical awareness among neurologists, as mercury exposure has been linked to over 250 neurological symptoms, including cognitive impairment, cerebellar ataxia, peripheral neuropathy, and psychiatric disturbances. The Indigenous and riverside populations in the Amazon present a high prevalence of cognitive and motor deficits, tremors, and sensory disturbances, which are associated with mercury body burdens. Diagnosis relies on a combination of clinical suspicion, environmental exposure history, and biomonitoring through hair and urine analyses. Given the widespread environmental contamination and potential long-term health consequences, neurologists must be vigilant in recognizing and managing mercury-related neurotoxicity, particularly in vulnerable Brazilian populations.

Keywords

Mercury - Mercury Poisoning, Nervous System

Authors' Contributions

Conceptualization: GMA, ELSD, MECL, JLMN; Formal analysis: GMA, ELSD; Funding acquisition: MECL, JLMN; Investigation: GMA, ELSD; Validation: GMA, ELSD; Writing – original draft: GMA, ELSD; Writing – review & editing: GMA, ELSD MECL, JLMN.


Data Availability Statement

All data supporting the findings of the present study are available on paper.


Editor-in-Chief: Ayrton Roberto Massaro's https://orcid.org/0000-0002-0487-5299.


Associate Editor: Orlando G. P. Barsottini's https://orcid.org/0000-0002-0107-0831.




Publication History

Received: 29 April 2025

Accepted: 21 June 2025

Article published online:
08 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Gustavo Maximiano-Alves, Eder Leandro da Silva Dantas, Maria Elena Crespo-Lopez, José Luiz Martins do Nascimento. A Brazilian Minamata disease? Neurologists must be aware of mercury exposure and intoxication. Arq Neuropsiquiatr 2025; 83: s00451811622.
DOI: 10.1055/s-0045-1811622