Editing Wilson's disease (section)

===Neuropsychiatric symptoms===
[[File:Wilson's Disease 5.jpg|thumb|Girl with Wilson's disease showing neurological symptoms]]
About half of the people with Wilson's disease have neurological or psychiatric symptoms. Most initially have mild cognitive deterioration and clumsiness, as well as changes in behavior. Specific neurological symptoms usually then follow, often in the form of [[parkinsonism]] (lead-pipe or cogwheel rigidity, [[bradykinesia]], and postural instability<ref name=Lorincz2010 />) with or without a typical hand [[tremor]], masked facial expressions, slurred speech, [[ataxia]] (lack of coordination), or [[dystonia]] (twisting and repetitive movements of part of the body). [[Seizure]]s and [[migraine]] appear to be more common in Wilson's disease.<ref name=Ala/> A characteristic tremor described as "wing-beating tremor" is encountered in many people with Wilson's; this is absent at rest but can be provoked by abducting the arms and flexing the elbows toward the midline.<ref>{{cite book|last=Pagonabarraga|first=J|title=Practical Neurology|date=2012|publisher=Wolters Kluwer/Lippincott Williams & Wilkins Heath|location=Philadelphia|isbn=978-1451142631|page=282|edition=4th|author2=Goetz, C |editor=Biller, J}}</ref>

Cognition can also be affected in Wilson's disease, in two non-mutually exclusive categories: [[frontal lobe disorder]] (may present as [[impulsivity]], impaired judgement, [[promiscuity]], [[apathy]], and [[executive dysfunction]] with poor planning and decision-making) and [[subcortical dementia]] (may present as slow thinking, memory loss, and [[executive dysfunction]], without signs of [[aphasia]], [[apraxia]], or [[agnosia]]). These cognitive involvements are thought to be related and closely linked to psychiatric manifestations of the disease.<ref name=Lorincz2010>{{cite journal | author=Lorincz MT | year=2010 | title=Neurologic Wilson's disease | journal=Annals of the New York Academy of Sciences | volume=1184 | issue=1 | pages=173–87 | doi=10.1111/j.1749-6632.2009.05109.x | pmid=20146697 | bibcode=2010NYASA1184..173L | hdl=2027.42/78731 | s2cid=2989668 | url=https://deepblue.lib.umich.edu/bitstream/2027.42/78731/1/j.1749-6632.2009.05109.x.pdf | hdl-access=free }}</ref>

Psychiatric problems due to Wilson's disease may include behavioral changes, [[clinical depression|depression]], [[anxiety disorders]], and [[psychosis]].<ref name=Ala/> Psychiatric symptoms are commonly seen in conjunction with neurological symptoms and are rarely manifested on their own. These symptoms are often poorly defined and can sometimes be attributed to other causes. Because of this, diagnosis of Wilson's disease is rarely made when only psychiatric symptoms are present.<ref name=Lorincz2010 />