Unilateral rubral tremors in Wilson′s disease treated with dimercaprol

Abstract

Tremors are reported as the most frequent neurological manifestation of Wilson's disease (WD) in some series. Postural tremors, rest tremors, action tremors and wing-beating (rubral) tremors are the different types of tremors seen in WD. We report a patient of WD with unilateral rubral tremors refractory to 1-year therapy with Penicillamine and anti-tremor medications. The tremors decreased considerably after adding chelation therapy with dimercaprol. Combination of Penicillamine and dimercaprol is an effective decoppering measure in rubral tremors of WD.

Advances in Treatment of Wilson Disease

“…In the last few decades BAL use has been reported only in isolated case reports. 34 There have been no recent trials or updates of use of BAL for WD.…”

Neurological manifestations in Wilson’s disease –possible treatment options for symptoms

“…levetiracetam). [6,27,32,33] Intention tremor, which typically occurs with other cerebellar symptoms resembling tremor observed in multiple sclerosis, occurs relatively rarely in patients with WD. In addition to kinetic hand tremor, it may involve head and trunk titubation.…”

Problematic Aspects of the Treatment of Wilson – Konovalov’s Disease

“…При усилении хелатирующей терапии -дополнительном назначении инъекций димеркапрола -тремор значительно уменьшился в течение месяца и пациент смог нормально функционировать. Также имеются данные о положительном эффекте таламотомии и DBS (deep brain stimulation) в случаях рефрактерного тремора при БВК [17].…”