title: Persistent akinetic-rigid side effects of neuroleptics may indicate Wilson's disease.
abstract: Here we report two cases, where neuroleptic treatment provoked persistent akinetic-rigid symptoms resulting in the diagnosis of Wilson's disease. No liver function abnormalities suggested Wilson's disease in one of the cases. In both cases, the akinetic-rigid symptoms were originally attributed to side effects of neuroleptics, but symptoms persisted after discontinuation of treatment. In one of the cases, T2-weighted cranial MRI indicated bilateral hyperintense signals in the basal ganglia. Our cases suggest that in a subgroup of Wilson's disease, dopamine receptor antagonists may provoke akinetic-rigid neurological symptoms possibly due to the damage of dopaminergic neurons. Persistent akinetic-rigid side effects of neuroleptics in young patients thus require diagnostic tests to exclude Wilson's disease even in unsuspected cases.
authors.affiliation: Department of Neurology, University of Pécs, Pécs.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Aschermann
authors.forename: Ferenc
authors.initials: F
authors.lastname: Szalay
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Schmidt
authors.forename: Sámuel
authors.initials: S
authors.lastname: Komoly
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Illés
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001479:Basal Ganglia / Q000473:pathology*; D018492:Dopamine Antagonists / Q000009:adverse effects; D006527:Hepatolenticular Degeneration / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009127:Muscle Rigidity / Q000139:chemically induced*
chemical_list: D014150:Antipsychotic Agents; D018492:Dopamine Antagonists