A case of apraxia of lid opening in Wilson's disease

ABSTRACT

Apraxia of lid opening is a nonparalytic motor abnormality characterized by difficulty in initiating the act of lid elevation. It has been reported in various extrapyramidal disorders(Parkinson's disease, Huntington's chorea, progressive supranuclear palsy), right middle cerebral infarction and Wilson's disease. We report a case of apraxia of opening in Wilson's disease, 34-year-old man was noted to have resting tremor and voluntary eye opening difficulty. Wilson's disease without Kayser-Fleisher ring was diagnosed by serum Cu, serum ceruloplasmin and liver biopsy. He was treated with D-penicillamine anticholinergics, amantadine, and levodopa.