Wilson's disease presenting as isolated obsessive-compulsive disorder.

Authors:
Dr. Tarun Ralot, MD,DM NEUROLOGY
Dr. Tarun Ralot, MD,DM NEUROLOGY
RNT MEDICAL COLLEGE
NEUROLOGY
udaipur, rajasthan | India
Shailesh Dixit
Shailesh Dixit
Institute of Molecular Medicine
India

Indian J Med Sci 2007 Nov;61(11):607-10

Department of Neurology, SMS Medical College, Jaipur, Rajasthan, India.

Wilson's disease (WD) is a genetic neurodegenerative disorder; it exhibits wide heterogeneity in symptoms and usually presents with liver disease and/ or neuropsychiatric manifestations. The common neurological manifestations observed are dysarthria, gait disturbance, dystonia, rigidity, tremor, dysphagia and chorea. The frequent psychiatric manifestations reported are personality and mood changes, depression, phobias, cognitive impairment, psychosis, anxiety, compulsive and impulsive behavior. Isolated obsessive-compulsive disorder (OCD) is a rare presentation of WD. Reported herein is a case of a 17-year-old boy with isolated OCD. He presented to the psychiatrist with symptoms of contamination obsessions and washing compulsions, along with compulsion of repeated feet tapping and was treated with adequate doses of fluoxetine for 6 months but did not improve. Later on, he was diagnosed as a case of WD and showed improvement with chelating and behavior therapy. This implies the importance of the occurrence of isolated psychological symptoms in WD.

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November 2007
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