Mercury must reach the central nervous system to cause central neurotoxicity. This requires both absorption into the body and distribution in a form that can penetrate the blood brain barrier.
Forms that can readily penetrate the blood brain barrier:
(1) unoxidized elemental mercury
(2) organic mercury
Risk factors for CNS toxicity:
(1) inhalation of elemental mercury (rapid absorption and distribution)
(2) high peak blood concentration (rather than chronic low levels)
(3) defect in the blood-brain barrier with increased permeability
(4) high cumulative mercury dose
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