Insomnia as a rare neuropsychiatric presentation of Wilson disease
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...
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| Format: | Article |
| Language: | English English |
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Malaysian Journal of Psychiatry Ejournal
2015
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| Online Access: | https://eprints.ums.edu.my/id/eprint/30183/1/Insomnia%20as%20a%20rare%20neuropsychiatric%20presentation%20of%20Wilson%20disease.pdf https://eprints.ums.edu.my/id/eprint/30183/2/Insomnia%20as%20a%20rare%20neuropsychiatric%20presentation%20of%20Wilson%20disease1.pdf |
| _version_ | 1796910816854802432 |
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| author | Pang, Nicholas Tze Ping Mat Rosly Mohamed S |
| author_facet | Pang, Nicholas Tze Ping Mat Rosly Mohamed S |
| author_sort | Pang, Nicholas Tze Ping |
| collection | UMS |
| description | 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. |
| first_indexed | 2024-03-06T03:09:55Z |
| format | Article |
| id | ums.eprints-30183 |
| institution | Universiti Malaysia Sabah |
| language | English English |
| last_indexed | 2024-03-06T03:09:55Z |
| publishDate | 2015 |
| publisher | Malaysian Journal of Psychiatry Ejournal |
| record_format | dspace |
| spelling | ums.eprints-301832021-07-31T08:02:37Z https://eprints.ums.edu.my/id/eprint/30183/ Insomnia as a rare neuropsychiatric presentation of Wilson disease Pang, Nicholas Tze Ping Mat Rosly Mohamed S R Medicine (General) RA Public aspects of medicine 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. Malaysian Journal of Psychiatry Ejournal 2015 Article PeerReviewed text en https://eprints.ums.edu.my/id/eprint/30183/1/Insomnia%20as%20a%20rare%20neuropsychiatric%20presentation%20of%20Wilson%20disease.pdf text en https://eprints.ums.edu.my/id/eprint/30183/2/Insomnia%20as%20a%20rare%20neuropsychiatric%20presentation%20of%20Wilson%20disease1.pdf 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 http://www.mjpsychiatry.org/index.php/mjp/article/view/369 |
| spellingShingle | R Medicine (General) RA Public aspects of medicine Pang, Nicholas Tze Ping Mat Rosly Mohamed S Insomnia as a rare neuropsychiatric presentation of Wilson disease |
| title | Insomnia as a rare neuropsychiatric presentation of Wilson disease |
| title_full | Insomnia as a rare neuropsychiatric presentation of Wilson disease |
| title_fullStr | Insomnia as a rare neuropsychiatric presentation of Wilson disease |
| title_full_unstemmed | Insomnia as a rare neuropsychiatric presentation of Wilson disease |
| title_short | Insomnia as a rare neuropsychiatric presentation of Wilson disease |
| title_sort | insomnia as a rare neuropsychiatric presentation of wilson disease |
| topic | R Medicine (General) RA Public aspects of medicine |
| url | https://eprints.ums.edu.my/id/eprint/30183/1/Insomnia%20as%20a%20rare%20neuropsychiatric%20presentation%20of%20Wilson%20disease.pdf https://eprints.ums.edu.my/id/eprint/30183/2/Insomnia%20as%20a%20rare%20neuropsychiatric%20presentation%20of%20Wilson%20disease1.pdf |
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