Persistent akinetic-rigid side effects of neuroleptics may indicate Wilson's disease

Ideggyogy Sz. 2007 Sep 30;60(9-10):404-5.

Abstract

Here we report two cases, where neuroleptic treatment provoked persistent akinetic-rigid symptoms resulting in the diagnosis of Wilson's disease. No liver function abnormalities suggested Wilson's disease in one of the cases. In both cases, the akinetic-rigid symptoms were originally attributed to side effects of neuroleptics, but symptoms persisted after discontinuation of treatment. In one of the cases, T2-weighted cranial MRI indicated bilateral hyperintense signals in the basal ganglia. Our cases suggest that in a subgroup of Wilson's disease, dopamine receptor antagonists may provoke akinetic-rigid neurological symptoms possibly due to the damage of dopaminergic neurons. Persistent akinetic-rigid side effects of neuroleptics in young patients thus require diagnostic tests to exclude Wilson's disease even in unsuspected cases.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Basal Ganglia / pathology*
  • Dopamine Antagonists / adverse effects
  • Hepatolenticular Degeneration / diagnosis*
  • Hepatolenticular Degeneration / pathology
  • Hepatolenticular Degeneration / physiopathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Muscle Rigidity / chemically induced*

Substances

  • Antipsychotic Agents
  • Dopamine Antagonists