Catatonia and Wilson's disease

ABSTRACT

A 17-year-old girl presented with lower limb oedema, chronic diarrhea, psychomotor retardation and insomnia. Laboratory investigations revealed a slight elevation of total bilirubin, hypoalbuminaemia, target cells in the blood film, thrombocytopenia, prolonged prothrombin and partial thromboplastin times noncorrected by vitamin K injections, increased urinary copper, decreased serum copper, and decreased blood ceruloplasmin. Active micronodular cirrhosis was found on liver biopsy. Slit lamp examination of the eyes revealed Kayser-Fleischer rings, and neuropsychiatric examination revealed a catatonic state with no obvious cardinal neurological manifestations of Wilson's disease. To date there are no reported cases of catatonia associated with Wilson's disease and we believe that our patient was the first patient to be described with catatonia associated with Wilson's disease. Wilson's disease should be considered in the differential diagnosis of catatonia