"Face of a Giant Panda" and "Beating Wings" in a Young Male

Abstract

Mutations in the gene coding for ATPase copper transporting beta polypeptide (ATP7B) cause Wilson's disease, located on chromosome 13. It has mainly hepatic and neurological presentations. Movement disorders are a characteristic finding in Wilson's disease, and "wing-beating tremors" are classical characteristics found on physical examination. We came across and managed a case of Wilson's disease with primarily neurological presentation with classical wing-beating tremors and "face of a giant panda" on radiology. As the patient had very typical findings and he also improved with the treatment, it will be beneficial to the clinicians in their daily practice to identify the disease seeing these clinical findings.

Keywords: batwing tremors; face of a giant panda; wilson's disease; wilson's disease with primarily neurological presentation; wing beating tremors.

Figure 1. Magnetic resonance imaging (MRI) of the brain revealing T2-weighted high-signal intensities in the caudate nucleus and putamen of bilateral basal ganglia, with sparing of the globus pallidus, ventrolateral thalami, the brainstem, and pontine region, giving an appearance of “face of a giant panda” (green arrow).