Resolution of Wing-Beating Tremor and Magnetic Resonance Imaging Lesions in Wilson's Disease Following Penicillamine

Tremor Other Hyperkinet Mov (N Y). 2024 Mar 4:14:9. doi: 10.5334/tohm.857. eCollection 2024.

Abstract

Background: The wing-beating tremor, characteristic of Wilson's disease (WD), is a disabling symptom that can be resistant to anti-copper and anti-tremor medications.

Phenomenology shown: This video illustrates severe bilateral wing-beating tremor, moderate head and lower limb tremors, mild cervical dystonia, and subtle cerebellar ataxia, with nearly resolution after penicillamine treatment.

Educational value: This case highlights a typical aspect of WD, emphasizing the importance of early detection and treatment, and its correlation with MRI findings.

Highlights: This case highlights the typical wing-beating tremor in Wilson's disease and its correlation with the involvement of the dentato-rubro-thalamic pathway. The early diagnosis and initiation of treatment with penicillamine resulted in an excellent clinical and radiological response.

Keywords: Hepatolenticular Degeneration; Penicillamine; Tremor.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Copper / pharmacology
  • Hepatolenticular Degeneration* / diagnostic imaging
  • Hepatolenticular Degeneration* / drug therapy
  • Humans
  • Magnetic Resonance Imaging
  • Penicillamine* / therapeutic use
  • Tremor / diagnostic imaging
  • Tremor / drug therapy
  • Tremor / etiology

Substances

  • Copper
  • Penicillamine