This article will discuss how advanced liver disease causes this rare debilitating disease with Mn deposition in the globus pallidus and striatum after it damages dopamine transporter (DAT), which plays an important role in maintaining dopamine levels via dopamine efflux at the synaptic level [11,12], and how it acts at the cellular level disrupting mitochondrial function and generating reactive oxygen species (ROS) causing widespread neuroinflammation and cell death [13]. The gene discussed is SLC6A3; the disease is liver disorder.