Manganese intoxificaton is a well-known cause of Parkinson's like syndrome.

We describe a 46-year-old man who had been occupationally exposed to manganese and report the case with hydrogen magnetic resonance spectroscopy (¹H MRS). Ratios of N-acetyl-aspartate (NAA) to creatine were significantly reduced in basal ganglia regions compared to normal subjects. The level of NAA was decreased in basal ganglia regions may indicate neuronal dysfunction. ¹H MRS can provide detailed information of brain damage, therefore the ¹H MRS is very useful in diagnosis of manganese intoxification.