Resolution of cerebral white matter lesions following long-term penicillamine therapy for Wilson's disease: report of a case.
Although lenticular gray matter lesions in Wilson's disease (WD) may resolve following long-term decoppering therapy, response of cerebral white matter lesions to such a treatment has not been reported. A patient with WD developed dystonia of the left hand and focal seizures involving the left upper limb with occasional generalization. CT disclosed a low density area in the right frontal white matter. Initiation of penicillamine therapy resulted in worsening of clinical manifestations, further extension of the right frontal lesion, and development of a new left parietal lesion. However, after five years of continued penicillamine therapy, clinical improvements were noted, including disappearance of the left parietal lesion and almost complete resolution of the right frontal lesion. The present case suggests that cerebral white matter lesions in WD may also respond to long-term chelating therapy.
Department of Neurology, Chang Gung Medical College, Taipei, Taiwan R.O.C.
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CC
Huang
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Chu
D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000473:pathology; D006527:Hepatolenticular Degeneration / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D010396:Penicillamine / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D010396:Penicillamine