Undulating tongue in Wilson′s disease

Abstract

We report an unusual occurrence of involuntary movement involving the tongue in a patient with confirmed Wilson's disease (WD). She manifested with slow, hypophonic speech and dysphagia of 4 months duration, associated with pseudobulbar affect, apathy, drooling and dystonia of upper extremities of 1 month duration. Our patient had an uncommon tongue movement which was arrhythmic. There was no feature to suggest tremor, chorea or dystonia. It might be described as athetoid as there was a writhing quality, but of lesser amplitude. Thus, the phenomenology was uncommon in clinical practice and the surface of the tongue was seen to “ripple” like a liquid surface agitated by an object or breeze. Isolated lingual dyskinesias are rare in WD. It is important to evaluate them for WD, a potentially treatable disorder.

Galloping tongue syndrome in a PRRT2 mutation carrier

“…1–5 The characteristics of these lingual movements have been variably described as transverse contractions, twisting, or undulating movements. 2–5 Although these movements were present with the tongue at rest in most of the reported patients, in some cases the movements were also observed during sustained action.…”