Wilson disease with an initial manifestation of polyneuropathy

Background: Recognition of Wilson disease (WD) is sometimes difficult because of its diverse manifestations. Peripheral neuropathy is rarely reported in the context of WD. Objective: To report an unusual patient with WD whose initial manifestation was peripheral neuropathy. Design: Case report. Setting: Neurology department in a tertiary referral center. Method: Personal observation. Result: A 17-year-old man, who was eventually diagnosed with WD, was initially seen with polyneuropathy at least 6 months prior to developing more typical symptoms of WD. Electrophysiological and pathological studies suggested a neuropathy of mixed type. Treatment for WD resulted in clinical and electrophysiological improvement. Conclusion: Wilson disease may initially appear as a treatable polyneuropathy.