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Wilson’s Disease with Wing-Beating Tremor

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

The common neurologic manifestations of Wilson’s disease (WD) are dysarthria, tremor, dystonia, parkinsonism, and gait disturbance. While all tremor types may occur in WD, postural and resting tremors are the most common. The classical proximal “wing-beating” tremor of WD is often missing in the early stages of the disease. When it does appear, it is often resistant to decoppering therapy and antitremor drugs and results in severe disability. Recent MRI studies indicate that WD tremor is associated with lesions of the globus pallidus, the head of the caudate nucleus, and the substantia nigra. There is some experience indicating that uncontrolled bilateral upper limb tremor may respond to thalamotomy.

Keywords

Public Health Internal Medicine Substantia Nigra Caudate Nucleus Severe Disability 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Wilson’s Disease w. wing-beating tremor.mp4 ( MP4 2,328KB)

The patient exhibits bilateral “wing-beating” tremor associated with mild head tremor and cervical dystonia.

References

  1. 1.
    Sudmeyer M, Saleh A, Wojtecki L, et al. Wilson’s disease tremor is associated with magnetic resonance imaging lesions in basal ganglia structures. Mov Disord. 2006;21:2134–9.PubMedCrossRefGoogle Scholar
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    Bhidayasiri R. Differential diagnosis of common tremor syndromes. Postgrad Med J. 2005;81:756–62.PubMedCentralPubMedCrossRefGoogle Scholar
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    Puschmann A, Wszolek ZK. Diagnosis and treatment of common forms of tremor. Semin Neurol. 2011;31:65–77.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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