Download PDF
Journal of Pediatric Neurology 2022; 20(06): 395-397
DOI: 10.1055/s-0041-1740365
Case Report

Laterotrusion (Side to Side) and Protrusion/Retraction Difficulty of Tongue in Two Children with Wilson's Disease

Roshan Koul 
1   Department of Pediatric Neurology, Institute of Liver and Biliary Sciences, Delhi, India
,
Arjun Maria
2   Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
,
Seema Alam
2   Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Involvement of tongue is uncommon in Wilson's disease (WD) in early stages. This is usually seen late when the patient has an established neurological WD associated with dyskinesia, dystonia, and tremors. In this article, we presented two children with tongue involvement in which there were slow laterotrusion (side to side) and protrusion and retraction movements. In the first child this was the early and only manifestation without any other neurological features while in the second child this was seen in a previously diagnosed WD. Slow tongue movements in any child with or without extrapyramidal features should be investigated to rule out a treatable condition like WD. Tongue involvement is common in children with different neurological/neuromuscular diseases, drugs, and other unknown conditions.

Keywords

tongue bradykinesia - Wilson's disease - children


Publication History

Received: 25 September 2021

Accepted: 03 September 2021

Article published online:
17 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Taly AB, Meenakshi-Sundaram S, Sinha S, Swamy HS, Arunodaya GR. Wilson disease: description of 282 patients evaluated over 3 decades. Medicine (Baltimore) 2007; 86 (02) 112-121
    CrossrefPubMedGoogle Scholar
  • 2 Liao KK, Wang SJ, Kwan SY, Kong KW, Wu ZA. Tongue dyskinesia as an early manifestation of Wilson disease. Brain Dev 1991; 13 (06) 451-453
    CrossrefPubMedGoogle Scholar
  • 3 Goez HR, Jacob FD, Yager JY. Lingual dyskinesia and tics: a novel presentation of copper-metabolism disorder. Pediatrics 2011; 127 (02) e505-e508
    CrossrefPubMedGoogle Scholar
  • 4 Kumar TS, Moses PD. Isolated tongue involvement—an unusual presentation of Wilson's disease of post graduate medicine. Letters 2005; 51: 337
    PubMedGoogle Scholar
  • 5 Nagappa M, Sinha S, Saini J, Bindu P, Taly A. Undulating tongue in Wilson's disease. Ann Indian Acad Neurol 2014; 17 (02) 225-226
    CrossrefPubMedGoogle Scholar
  • 6 Choudhary N, Joshi L, Duggal A, Puri V, Khwaja GA. Isolated lingual involvement in Wilson's disease. J Neurosci Rural Pract 2015; 6 (03) 431-433
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Yoshida K. Botulinum neurotoxin therapy for lingual dystonia using an individualized injection method based on clinical features. Toxins (Basel) 2019; 11 (01) 51
    CrossrefPubMedGoogle Scholar
  • 8 Esper CD, Freeman A, Factor SA. Lingual protrusion dystonia: frequency, etiology and botulinum toxin therapy. Parkinsonism Relat Disord 2010; 16 (07) 438-441
    CrossrefPubMedGoogle Scholar