“Horseshoe Moustache” sign

“horseshoe moustache” sign seen in MRI in hypermanganesemia

Characteristic brain MRI finding is involvement of pontine tegmentum on T1 axial images (due to affliction of central tegmental tract [CTT]) with sparing of ventral pons giving rise to “horseshoe moustache” sign.

Seen in severe hypermanganesaemia

“Cock-walk” gait and “horseshoe moustache” sign on MRI seen in inherited hypermanganesemia