Abstract

We reported a 33-year-old man with a severe neurologic type of Wilson's disease. Neurological examinations revealed apathy, dysphagia, rigidity, bradykinesia and loss of postural reflexes. He was treated with a low copper diet, a combination of trientine and zinc, and rehabilitation. However, no significant change in ADL was observed in the first 11 months of therapy. After that, improvement began and continued for a period of an additional 9 months. Ultimately, neurologic and psychiatric manifestations disappeared and the Barthel Index improved from 30 to 100. A long period was required until substantial improvement began and reached a plateau. The rehabilitation during the period prevented disuse, and then promoted the recovery of functions. On the initiation of therapy, it is difficult to estimate the onset time of recovery or ultimate state of functions. Therefore, it is important to maintain a positive attitude toward the disease during the long-term follow-up.

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