Jukić Ivana, Titlić Marina, Tonkić Ante, Dodig Goran, Rogosić Veljko
Department of Internal medicine, Clinical Hospital Split, Croatia.
Psychiatr Danub. 2006 Jun;18(1-2):105-7.
In this article we present a case of a 26-year-old woman with clinical picture of acute psychosis, as the first and main manifestation of Wilson's disease, who developed abnormal involuntary choreoathetoid limb movements, few days after initiation of neuroleptic therapy. At the first movement neurological symptoms were misinterpreted as side effect of haloperidol, but consulted neurologist suggested additional diagnostic procedure which confirmed Wilson's disease. Psychiatric symptomatology and abnormal involuntary movements were the clinical manifestation of this disease, which improved with neuroleptic and chelating treatment. Interdisciplinary approach with good collaboration of psychiatrists and neurologists is crucial for Wilson's disease, because early diagnosis and treatment without delay is critical to the prognosis. This case serves as a reminder that involuntary movements can be side effect of antipsychotics but also the clinical manifestation of some illnesses, for example Wilson's, Huntington's and Fuhr's diseases.
在本文中,我们介绍了一例26岁女性病例,其急性精神病临床表现为肝豆状核变性的首发及主要表现,在开始使用抗精神病药物治疗几天后出现异常的不自主肢体舞蹈样徐动症。最初,运动神经系统症状被误诊为氟哌啶醇的副作用,但咨询神经科医生后建议进行进一步诊断程序,结果确诊为肝豆状核变性。精神症状和异常不自主运动是该疾病的临床表现,通过抗精神病药物和螯合治疗后有所改善。精神科医生和神经科医生的良好合作采取跨学科方法对肝豆状核变性至关重要,因为早期诊断和及时治疗对预后至关重要。该病例提醒我们,不自主运动可能是抗精神病药物的副作用,但也可能是某些疾病的临床表现,例如肝豆状核变性、亨廷顿病和福尔病。