# Manifestation of “Wing‐Beating” Tremors Along With Appearance of the “Giant Panda” Sign on Brain MRI in Neuro Wilson's Disease Due to Treatment Failure: A Case Report

## TL;DR

A patient with Wilson's disease showed worsening symptoms and a specific MRI sign after treatment with zinc acetate, highlighting the need for copper chelators as first-line therapy.

## Contribution

Highlights the clinical significance of the 'giant panda' MRI sign and treatment failure with zinc acetate in neuro Wilson's disease.

## Key findings

- Wing-beating tremors and 'giant panda' sign appeared after 1 year of zinc acetate treatment.
- Switching to copper chelator therapy is crucial for better prognosis and preventing irreversible damage.

## Abstract

We report a patient of neuro Wilson's disease who presented with “wing‐beating” tremors and “giant panda” sign on magnetic resonance imaging, 1 year after initiation of treatment with zinc acetate. We focus on the importance of initiating copper chelator therapy as the first line treatment as it improves the prognosis and prevents irreversible complications.