title: Is blinking of the eyes affected in extrapyramidal disorders? An interesting observation in a patient with Wilson disease.
abstract: Blinking of eye is a routine human activity which seldom attracts any attention of clinicians in health and disease. There is experimental evidence that blink rate is affected in extrapyramidal disorders affecting the balance of these neurotransmitters. However, no observations regarding blink rate in Wilson disease (WD) have been reported previously. We report a patient of WD with an increased spontaneous blink rate. A 24-year-old lady presented complaining of tremulousness of both upper limbs and head for 2 years, dysphagia and difficulty in speaking for 1.5 years and abnormal behaviour for last 1 year. We observed that her blink rate at rest was 32/min. Serum ceruloplasmin level was low (0.08 g/l). The patient was started on therapy with D-penicillamine, zinc sulphate, levodopa-carbidopa and trihexiphenidyl. At 1-month follow-up, patient's tremors were markedly decreased and blink rate at rest was decreased to 12/min.
authors.affiliation: Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India. drrajeshverma32@yahoo.com
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.forename: Rakesh
authors.initials: R
authors.lastname: Lalla
authors.forename: Tushar B
authors.initials: TB
authors.lastname: Patil
mesh_terms: D000328:Adult; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D001767:Blinking / Q000187:drug effects / Q000502:physiology; D002230:Carbidopa / Q000627:therapeutic use; D002570:Ceruloplasmin / Q000032:analysis; D004359:Drug Therapy, Combination; D005260:Female; D006527:Hepatolenticular Degeneration / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D010396:Penicillamine / Q000627:therapeutic use; D014282:Trihexyphenidyl / Q000627:therapeutic use; D019287:Zinc Sulfate / Q000627:therapeutic use
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa; D014282:Trihexyphenidyl; D019287:Zinc Sulfate; D002570:Ceruloplasmin; D010396:Penicillamine; D002230:Carbidopa