Objective: Objective: To determine the early clinical features that predict younger people who has Wilson’s disease(WD).

Background: Backround: WD is fatal neurodegenerative  disorder that is characterized clinically by marked parkinsonism, autonomic failure, psychiatric symptoms and liver dysfunction in various combinations.

Methods: : A case with clinical diagnosis of WD were in natural history study and neurological examination every 3 months.

Results: Patient S., 20years old, boy. He suffered flu- like symptoms in 2010 then affect sleep problem and hallucination. Treated at psychiatric hospital due to paranoid syndrome and taken antipsychotic treatment. Since July 2011 the young man began again to have fever, bradikinesia of the neck with rigidity, swallowing and speech problems, excessive sweating and insomnia. Psychiatric symptoms developing slowly  progressive: anxiety, mood disturbance and restless. The boy from childhood has liver dysfunction as skin a change.

Neurological examination: Communication is not possible. Slight aggressive behavior. Jaw joint spasm. Extreme rigidity of neck muscles. Dysphagia, anarthria. Increased muscle tone of all extremities.

Brain MRI: both basal ganglia are seen hyperintensity. N.ruber and substantia nigra in the midbrain are seen hypointensity in T2 sequencies.  

Ophthalmological exam: Kayser-Fleischer ring seen

Conclusions: In the case with WD was very difficult because of psychiatric symptoms began as a paranoid syndrome and not easily identify from drug induced parkinsonism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/wilsons-disease-a-mongolian-case/