open access

Vol 47, No 5 (2013)
OPIS PRZYPADKU
Submitted: 2012-08-27
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Acute focal dystonia induced by a tricyclic antidepressant in a patient with Wilson disease: a case report

Tomasz Litwin, Grzegorz Chabik, Anna Członkowska
DOI: 10.5114/ninp.2013.38230
·
Neurol Neurochir Pol 2013;47(5):502-506.

open access

Vol 47, No 5 (2013)
OPIS PRZYPADKU
Submitted: 2012-08-27

Abstract

The authors present the case of a 19-year-old patient with Wilson disease (WD) who developed symptoms of acute focal dystonia of the left hand (a ‘starfish’ hand presentation) shortly after treatment with the tricyclic antidepressant clomipramine. The diagnosis of WD was made 8 months earlier based on abnormal copper metabolism parameters and was confirmed by genetic testing. Initially, the patient presented with akathisia, sialorrhea, oromandibular dystonia (occasionally grimacing) and slight dysarthria. The patient's symptoms diminished after treatment with d-penicillamine was initiated. No further deterioration was observed after copper-chelating therapy was started.

The authors diagnosed acute focal dystonia induced by clomipramine.

Botulinum toxin and intensive rehabilitation was initiated; complete regression of hand dystonia was observed. Based on the case, the authors suggest that care should be exercised with regard to starting medications that could potentially impact the extrapyramidal system in WD patients.

Abstract

The authors present the case of a 19-year-old patient with Wilson disease (WD) who developed symptoms of acute focal dystonia of the left hand (a ‘starfish’ hand presentation) shortly after treatment with the tricyclic antidepressant clomipramine. The diagnosis of WD was made 8 months earlier based on abnormal copper metabolism parameters and was confirmed by genetic testing. Initially, the patient presented with akathisia, sialorrhea, oromandibular dystonia (occasionally grimacing) and slight dysarthria. The patient's symptoms diminished after treatment with d-penicillamine was initiated. No further deterioration was observed after copper-chelating therapy was started.

The authors diagnosed acute focal dystonia induced by clomipramine.

Botulinum toxin and intensive rehabilitation was initiated; complete regression of hand dystonia was observed. Based on the case, the authors suggest that care should be exercised with regard to starting medications that could potentially impact the extrapyramidal system in WD patients.

Get Citation

Keywords

Wilson disease, dystonia, clomipramine

About this article
Title

Acute focal dystonia induced by a tricyclic antidepressant in a patient with Wilson disease: a case report

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 5 (2013)

Pages

502-506

DOI

10.5114/ninp.2013.38230

Bibliographic record

Neurol Neurochir Pol 2013;47(5):502-506.

Keywords

Wilson disease
dystonia
clomipramine

Authors

Tomasz Litwin
Grzegorz Chabik
Anna Członkowska

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