6D85.2

Dementia due to exposure to heavy metals and other toxins

Demência devido à exposição a metais pesados e outras toxinas

Definition

Dementia due to exposure to heavy metals and other toxins caused by toxic exposure to specific heavy metals such as aluminium from dialysis water, lead, mercury or manganese. The characteristic cognitive impairments in Dementia due to exposure to heavy metals and other toxins depend on the specific heavy metal or toxin that the individual has been exposed to but can affect any cognitive domain. Onset of symptoms is related to exposure and progression can be rapid especially with acute exposure. In many cases, symptoms are reversible when exposure is identified and ceases. Investigations such as brain imaging or neurophysiological testing may be abnormal. Lead poisoning is associated with abnormalities on brain imaging including widespread calcification and increased signal on MRI T2-weighted images of periventricular white matter, basal ganglia hypothalamus and pons. Dementia due to aluminium toxicity may demonstrate characteristic paroxysmal high-voltage delta EEG changes. Examination may make evident other features such as peripheral neuropathy in the case of lead, arsenic, or mercury.

Coding Note

This category should never be used in primary tabulation. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of dementia in diseases classified elsewhere. When dementia is due to multiple aetiologies, code all that apply.

Diagnostic Criteria

All diagnostic requirements for Dementia are met.
Dementia is presumed to be attributable to toxic exposure to specific heavy metals such as aluminum from dialysis water, lead, mercury or manganese, as demonstrated by neuropsychological test data, neuroimaging data, medical tests, and/or clinical history.
The characteristic neurocognitive impairments in Dementia Due to Exposure to Heavy Metals and Other Toxins depend on the specific heavy metal or toxin that the individual has been exposed to but can affect any cognitive domain.
Onset of symptoms is related to exposure and progression can be rapid especially with acute exposure.
In some cases, symptoms are reversible when exposure is identified and ceases.

Note: An appropriate diagnosis from the grouping of NE61 Harmful Effects of or Exposure to Noxious Substances, Chiefly Nonmedicinal as to Source, Not Elsewhere Classified should also be assigned.

Exclusions

Dementia due to psychoactive substances including medications

Index Terms

Dementia due to exposure to heavy metals and other toxins

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