Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2014  |  Volume : 17  |  Issue : 2  |  Page : 225-226

Undulating tongue in Wilson's disease


1 Department of Neurology, National Institute of Mental Health and NeuroSciences NIMHANS), Bangalore, India
2 Department of Neuroimaging and Interventional Radiology (NIIR), National Institute of Mental Health and NeuroSciences NIMHANS), Bangalore, India

Correspondence Address:
S Sinha
MD, DM, Additional Professor of Neurology, Department of Neurology National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.132646

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We report an unusual occurrence of involuntary movement involving the tongue in a patient with confirmed Wilson's disease (WD). She manifested with slow, hypophonic speech and dysphagia of 4 months duration, associated with pseudobulbar affect, apathy, drooling and dystonia of upper extremities of 1 month duration. Our patient had an uncommon tongue movement which was arrhythmic. There was no feature to suggest tremor, chorea or dystonia. It might be described as athetoid as there was a writhing quality, but of lesser amplitude. Thus, the phenomenology was uncommon in clinical practice and the surface of the tongue was seen to "ripple" like a liquid surface agitated by an object or breeze. Isolated lingual dyskinesias are rare in WD. It is important to evaluate them for WD, a potentially treatable disorder.


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