Magnetic Resonance Imaging of Brain in Patient with Late-Onset Wilson’s Disease: A Case Report and Review of Literature

Noha Abdelfattah Ahmed Madkour^1,

¹Department of Radiodiagnosis, Kasr Alainy hospital, Cairo University, Cairo, Egypt

Cite this paper:
Noha Abdelfattah Ahmed Madkour. Magnetic Resonance Imaging of Brain in Patient with Late-Onset Wilson’s Disease: A Case Report and Review of Literature. American Journal of Medical Case Reports. 2018; 6(3):55-57. doi: 10.12691/ajmcr-6-3-5

Abstract

Wilson’s disease is a worldwide inherent gene disorder leads to copper deposition in various tissues. Recently, wilson’s disease is classified according to onset of symptoms into early-onset and late-onset wilson. Reported a 56-year-old male patient presenting with dysarthria and dyskinesia. Laboratory tests revealed elevated urinary cupper without elevation of liver function tests. Magnetic resonance imaging of the brain was performed and revealed typical bilateral putamena and midbrain tegmental T2 hyperintensity “Face of giant Panda” sign which are reliable imaging features of wilson’s disease and the case represents a late-onset type. Medical treatment was prescribed for the patient with regular follow up.

Keywords:
copper late-onset wilson magnetic resonance imaging brain face of giant Panda

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References:

[1]	Bandmann O, Weiss KH & Kaler SG. Wilson's disease and other neurological copper disorders. The Lancet Neurology, 2015; 14(1), 103-113.
[2]	Park RH, McCabe P, Fell GS & Russell RI. Wilson’s disease in Scotland. Gut. 1991; 32(12): 1541-5.
[3]	Zhang Y & Wu ZY. Wilson's disease in Asia. Neurology Asia, 2011; 16(2): 103-109.
[4]	Machado A, Fen Chien H & Mitiko Deguti M, et al. Neurological manifestations in Wilson's disease: Report of 119 cases. Movement disorders, 2006;21(12), 2192-2196.
[5]	Ferenci P, Czlonkowska A & Merle U, et al. Late onset Wilson disease. Gastroenterology 2007; 132: 1294-1298.
[6]	Ferenci P. Phenotype–genotype correlations in patients with Wilson's disease. Annals of the New York Academy of Sciences. 2014 May 1; 1315(1): 1-5.
[7]	Rosencrantz R & Schilsky M. Wilson disease: pathogenesis and clinical considerations in diagnosis and treatment. Semin Liver Dis 2011; 31: 245-259.
[8]	Hegde AN, Mohan S, Lath N & Lim CT. Differential diagnosis for bilateral abnormalities of the basal ganglia and thalamus. Radiographics. 2011 Jan 19; 31(1): 5-30.
[9]	Saatci I, Topcu M & Baltaoglu FF, et al. Cranial MR findings in Wilson's disease. Acta Radiologica, 1997; 38(2), 250-258.
[10]	Kuruvilla A and Joseph S. ‘Face of the giant Panda’ sign in Wilson’s disease: revisited. Neurol India, 2000; 48: 395-396.
[11]	Prashanth LK, Sinha S, Taly AB & Vasudev MK. Do MRI features distinguish Wilson’s disease from other early onset extrapyramidal disorders? An analysis of 100 cases. Mov Disord, 2010; 25: 672-678.
[12]	Van Wassenaer-van Hall HN, Van den Heuvel AG, Algra A, Hoogenraad TU & Mali WP. Wilson disease: findings at MR imaging and CT of the brain with clinical correlation. Radiology. 1996 Feb; 198(2): 531-6.
[13]	Das SK, & Ray K. Wilson's disease: an update. Nature clinical practice Neurology, 2006; 2(9), 482-493.
[14]	Sinha S, Taly AB, Ravishankar S, et al. Wilson’s disease: cranial MRI observations and clinical correlation. Neuroradiology. 2006 Sep 1; 48(9): 613-21.
[15]	Hitoshi S, Iwata M & Yoshikawa K: Mid-brain pathology of Wilson's disease: MRI analysis of three cases. J Neurol Neurosurg Psychiatry 1991;54(7): 624-626.
[16]	Gupta A, Chakravarthi S & Goyal MK. ‘Face of giant panda’: a rare imaging sign in Wilson’s disease. QJM: An International Journal of Medicine, 2013; 107(7), 579-579.
[17]	Tao TY and Gitlin JD. Hepatic copper metabolism: insights from genetic disease. Hepatology 2003; 37: 1241-1247.
[18]	European Association For The Study Of The Liver. Clinical Practice Guidelines: Wilson’s disease. J Hepatol. 2012; 56(3): 671-85.
[19]	Gitlin JD. Wilson disease. Gastroenterology 2003; 125: 1868-1877.
[20]	Lo CP, Chen SY & Lee KW, et al. Brain injury after acute carbon monoxide poisoning: early and late complications. American Journal of Roentgenology. 2007 Oct; 189(4): W205-11.
[21]	O’Donnel P, Buxton PJ, Pitkin A & Jarvis LJ. The magnetic resonance imaging appearances of the brain in acute carbon monoxide poisoning. Clin Radiol 2000; 55: 273-280.
[22]	Zuccoli G, Gallucci M & Capellades J, et al. Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients. Am J Neuroradiol 2007; 28: 1328-1331.
[23]	Zeidler M, Sellar RJ & Collie DA, et al. The pulvinar sign on magnetic resonance imaging in variant Creutzfeldt-Jakob disease. Lancet 2000; 355: 1412-18.
[24]	Kumar S, Misra UK, Kalita J, Salwani V, Gupta RK & Gujral R. MRI in Japanese encephalitis. Neuroradiology 1997; 39: 180-184.
[25]	Singh P, Kalra N, Ratho RK, Shankar S, Khandelwal N & Suri S. Coexistent neurocysticercosis and Japanese B encephalitis: MR imaging correlation. AJNR Am J Neuroradiol 2001; 22: 1131-1136.