Psychological signs as the only presentation of Wilson's disease in an 11 year-old boy (a case report)

Wilson’s disease (WD) is a rare autosomal recessive disease due to copper metabolism disturbance. The clinical presentation spectrum of Wilson’s disease is wide and initial findings of the disease depend on the organ involved. Neurologic disorders can develop insidiously or precipitously with intention tremor, dysarthria, rigid dystonia, parkinsonism, deterioration in school performance or behavioral changes. The aim of this article is presenting an 11-year old boy with chief complaint of falling and upper limb spasm referred to our center. His symptoms began from 6 month earlier as mood instability (prolonged spontaneous crying). He was also suffering from occasionally tremor and micrographia. Initial work ups were normal and with diagnosis of depression and psychiatric problems he was undergone treatment of fluoxetine and risperidone. Finally, concluded that Wilson’s disease should be considered in the diagnosis of all children with psychiatric and musculoskeletal symptoms.