Wilson's disease and multiple sclerosis

Introduction: Wilson's disease is a rare autosomal recessive disorder of hepatic copper transport leading to hepatic but also to highly variable neurological symptoms with extrapyramidal motor and cerebellar manifestation. Overlap of symptoms and also of results of multimodal evoked potentials to other central nervous system disorders as Multiple Sclerosis occur and sometimes complicate the diagnosis.

Case report: We report a 38 year old male patient who was diagnosed with a hepatic form of Wilson's disease at age 12 and with Multiple Sclerosis at age 36. Intravenous radio copper test confirmed the diagnosis of Wilson's disease whereas the diagnosis of Multiple Sclerosis was made after occurrence of transient sensory disturbances in both legs on the basis of typical changes in the MRI and cerebrospinal fluid as well as demyelinating changes in the multimodal evoked potentials.

Discussion: Although Wilson's disease and Multiple Sclerosis are known as distinct diseases with a completely different pathophysiology, symptoms and results of evoked potentials overlap and originally there is a common historic background. Thus, similarities and differences of symptoms and results of evoked potentials in both disorders are discussed.