Dance to diagnosis: The silent signs of Wilson's Disease

New Indian Express

30-04-2025

For nearly four years, a young woman in Hyderabad walked with what looked like an unusual rhythm, almost as if she were dancing. To her family, it was unusual, perhaps, but not alarming. It was only recently, when her condition worsened, that a medical evaluation revealed the truth — the involuntary movements were a symptom of Wilson's Disease, a rare and potentially life-threatening genetic disorder. This unusual case has brought attention to a condition that is often misdiagnosed or entirely overlooked, especially in young adults.
A hidden threat
Wilson's Disease causes copper to accumulate in vital organs, especially the liver and brain. Left untreated, it can lead to severe neurological and psychiatric symptoms, liver failure, and death. While it is rare — estimated to affect one in 30,000 people — it often goes undetected for years due to its wide-ranging and misleading symptoms.
Dr Suresh Babu P, head of neurology at Arete Hospitals, says he sees four to five cases a year in his practice. 'Many patients have difficulties in speaking or swallowing. They are first taken to ENT specialists and only later referred to neurologists,' he explains.
Others may show unusual motor symptoms. 'Some patients come in with involuntary muscle postures, dystonia, or chorea,' he says, adding, 'Chorea is derived from the word 'choreography'. It's literally a dance-like movement. And then there's rubral tremor — shaking starts from the shoulder and elbow, which is something that sets Wilson's apart from typical Parkinson's Disease.'
A misunderstood disease
The Hyderabad case isn't an isolated example. Dr Suresh recalls another patient, a young boy initially thought to be a road accident victim. 'His MRI showed something unusual, but it was linked to trauma. A year later, he was in a wheelchair. We diagnosed Wilson's and, with treatment, he recovered the ability to walk.'
Such misdiagnoses are not uncommon. Wilson's Disease can resemble conditions like Parkinson's Disease, psychiatric disorders, or general developmental delays. In fact, says Dr Suresh, psychiatric symptoms are sometimes the only early sign, making it even harder to catch.
The hidden signs
Dr Sreekanth Vemula, founder of Magna Neurology Clinic in Madhapur and consultant neurologist at Apollo Hospitals in Jubilee Hills, also sees young patients with movement disorders caused by Wilson's. 'One key sign is a 'wing-beating tremor', where the arms move rhythmically like bird wings,' he says, noting, 'It's subtle, but distinctive.'
Other symptoms include myoclonus, which are sudden, jerky movements, or cognitive slowing. 'When a young adult shows these signs along with slowed thinking or psychiatric issues, and has a characteristic eye feature known as the Kayser-Fleischer ring — which is more common in families with a history of close relatives marrying — it's a red flag,' Dr Sreekanth adds.
The awareness gap
Despite its treatability, Wilson's Disease is frequently diagnosed late, sometimes only when irreversible damage has occurred. The challenge, experts say, lies less in public ignorance and more in clinical oversight.
'This isn't a common disease,' says Dr Suresh, stating, 'But when a patient presents with early-onset tremors, slurred speech, or behavioural changes, doctors need to think of Wilson's. It may be rare, but it's not invisible.'
Dr Sreekanth echoes the concern. 'There is some growing awareness, especially through social media, but it needs to improve. Early detection can make all the difference.'
In the Hyderabad case, the family had not sought medical help for years, believing the woman's walk was just an oddity. Her case is a powerful reminder of how easily rare disorders can slip through the cracks — until it's almost too late.
Why it matters
Wilson's Disease may not warrant widespread public screening, say doctors, but increased precautions, especially among primary care providers, could change outcomes for many young patients.
When a young person begins moving strangely, speaking differently, or behaving unusually, it's worth asking: Is it personality or pathology? As the dancing woman case shows, sometimes the body is speaking in a language only a trained eye can understand.