Wilson's disease and the neuroleptic malignant syndrome

Wilson's Disease (Hepatolenticular degeneration) is an uncommon disorder of copper metabolism, characterised by excessive copper deposition in the liver, brain and eyes. Psychiatric symptoms were prominent in eight of the twelve patients originally described by Wilson some 88 years ago¹. Since then a wide range of psychiatric presentations have been documented including behavioural disturbances, affective psychoses, schizophrenia-like psychoses, intellectual deterioration and dementia.²'³ Here we describe a patient who presented with a psychiatric disturbance, was treated with neuroleptic medication and subsequently developed Neuroleptic Malignant Syndrome (NMS).