Insomnia as a rare neuropsychiatric presentation of Wilson disease

Pang, Nicholas Tze Ping and Mat Rosly and Mohamed S (2015) Insomnia as a rare neuropsychiatric presentation of Wilson disease. Malaysian Journal of Psychiatry Ejournal, 24. pp. 1-5. ISSN 2232-0385

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Abstract

Objective: Wilson’s disease (WD) is a rare disorder of copper metabolism with hepatic, neurological and psychiatric manifestations. This case describes insomnia as a rare primary psychiatric presentation of WD. Methods: An 18-year-old gentleman presented with three months of poor sleep. There was no depressive, manic, psychotic, anxiety or cognitive symptoms. He was diagnosed with WD three months ago. Physical examination was normal however Kayser-Fleischer rings were noted. MRI brain demonstrated symmetrical signal abnormalities noted in the head of the caudate nucleus, putamen and globus pallidus. His insomnia worsened on increased dose of chelating agent so the agent was reduced. Longitudinally he developed depressive symptoms so has been commenced on mirtazapine. Discussion: Psychiatric complications of WD are found in initial presentation in 30-67% cases. Underlying scientific mechanisms proposed include brain copper toxicity, presynaptic SERT availability, and alternative metabolic influences. Treatment focuses on chelating agents and psychotropic augmentation.

Item Type:	Article
Keyword:	Wilson’s Disease , Insomnia , Psychiatry
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine
Department:	FACULTY > Faculty of Medicine and Health Sciences
Depositing User:	SITI AZIZAH BINTI IDRIS -
Date Deposited:	31 Jul 2021 11:56
Last Modified:	31 Jul 2021 16:02
URI:	https://eprints.ums.edu.my/id/eprint/30183

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