[Stereotyped movements in Wilson's disease: a case report]

Abstract

A 45-year-old Japanese man was admitted to our hospital because of persistent appearance of repetitive, purposeless stereotyped movements such as clapping the hands behind his back, scrubbing or rubbing movements of the hands. Laboratory examination showed low plasma copper and ceruloplasmin concentration. He was diagnosed as having Wilson's disease. Brain MRI revealed degeneration of the striatum and pallidum as well as atrophy of brainstem. Single photon emission computer tomographic scan (SPECT) showed hypoperfusion in the bilateral frontal lobe as well as basal ganglia. It is rare to see stereotyped movements in patients with Wilson's disease. Stereotyped movements observed in the present patient was not likely to be a simple stereotypy, since appearance of the motor acts was variable and complex. We consider that his stereotyped movement is a type of clonic perseveration induced by dysfunctioning of frontal cortico-basal ganglia-thalamo-cortical loops.