The effect of penicillamine on seizure threshold. The role of pyridoxine.

Abstract

THE PRESENCE of clinical seizures in Wilson's disease is unusual. When seizures do occur, they tend to appear late in the course of the disease, often shortly before death. 1-3 In more than half the cases of Wilson's disease in which Heller and Kooi 4 were able to document electroencephalographic changes, the records were abnormal and the degree of generalized abnormality tended to parallel the overall severity of the clinical course. 4 More recently, however, Hansotia et al 3 showed that while mild nonspecific changes in the EEG bore no clear relationship to the degree of central nervous system involvement, marked abnormalities including seizure discharges were seen only with severe complications of the disease. In 1966, Gibbs and Walshe 5 reported a patient with Wilson's disease who developed Jacksonian epilepsy after 26 months of penicillamine therapy at a time when the neurological manifestations otherwise were showing a striking improvement. Smith