Wilson’s Disease

Wilson’s disease is a rare genetic condition that causes copper to accumulate in the liver, brain and other organs. While liver problems are common, many adults experience neurological and psychiatric symptoms such as tremor, dystonia, slowness of movement and changes in mood or cognition.

At The Royal Buckinghamshire Hospital, we support adults who have ongoing neurological effects of Wilson’s disease after medical treatment has been started and the condition is stable. Our consultant-led inpatient neurorehabilitation aims to improve movement, speech, swallowing, cognition and everyday independence.

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Neurological Symptoms

Neurological presentation varies, but may include:

• Tremor (action or rest), dystonia, or muscle rigidity
• Bradykinesia and gait disturbance resembling parkinsonism
• Dysarthria (slurred or quiet speech) and dysphagia (swallowing difficulty)
• Poor coordination, clumsiness and postural instability
• Cognitive slowing, attention and executive function problems
• Mood and behavioural changes (anxiety, irritability, depression)

These symptoms can persist even when copper levels are controlled, and often benefit from targeted rehabilitation.

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Diagnosis And Medical Treatment (Overview)

Diagnosis is made by specialist teams using a combination of:

• Blood and urine tests for copper metabolism
• Slit-lamp eye exam for Kayser–Fleischer rings
• Liver assessment (imaging/biopsy in some cases)
• Genetic testing

Medical treatment (initiated and monitored by hepatology/neurology teams) may include chelating agents or zinc therapy to reduce copper. Some people require liver-focused care. We do not provide acute hepatology or surgery on site; our role is neurological rehabilitation once medically stable.

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How We Can Help: Inpatient Neurorehabilitation

Our multidisciplinary programmes target the movement, speech and cognitive effects of Wilson’s disease.

Physiotherapy

• Gait retraining, balance and falls prevention
• Cueing strategies for parkinsonian features
• Strength, flexibility and endurance work
• Dystonia positioning and spasm management (non-pharmacological)

Occupational Therapy

• Upper-limb control and fine-motor skills for daily tasks
• Energy conservation and fatigue management
• Home and equipment recommendations to maximise independence
• Handwriting, typing and task simplification strategies

Speech And Language Therapy

• Dysarthria management: breath support, articulation and voice projection
• Swallowing assessment and safe-eating strategies; texture and pacing advice
• Communication aids where appropriate

Neuropsychology

• Attention, planning and memory strategies
• Mood and adjustment support for long-term conditions
• Education for patients and families to build self-management

Discharge Planning

• Home exercise plans and maintenance routines
• Community therapy handover and carer education
• Advice on falls, fatigue and daily structure

Explore Our Rehabilitation Centre

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When To Consider Inpatient Rehab

• Persistent tremor, dystonia or gait problems limiting independence
• Speech or swallowing changes affecting confidence, safety or nutrition
• Cognitive or mood issues interfering with daily life
• Need for co-ordinated input from multiple therapy disciplines
• Limited progress with outpatient therapy alone

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Living Well With Wilson’s Disease

• Maintain treatment adherence and regular specialist follow-up for copper control
• Keep a structured daily routine with planned activity and rest
• Use cueing strategies (counting, metronome, visual markers) for gait and fine-motor tasks
• Optimise sleep, hydration and nutrition; review swallow safety regularly
• Involve family or carers in therapy sessions to embed techniques at home