A Diagnosis Hidden in Plain Sight: A Rare Presentation of Isolated Dysarthria in Wilson's Disease—A Case Report

A clinical picture of isolated dysarthria is relatively uncommon, and the underlying condition causing it can be easily misdiagnosed. In this case, a 24-year-old Indian male presented with complaints of slurring of speech occurring for the past 9 months. The patient also complained of difficulty swallowing food using his tongue. There was also a history of excessive drooling of saliva. There was no history of involuntary movements suggestive of tremor, limb dystonia, Parkinsonism, ataxia, behavioral abnormalities, or any significant cognitive impairment. The patient's parents had a non-consanguineous marriage, and there were no similar complaints among the patient's siblings. The patient was started on copper chelating agents and speech therapy and noticed remarkable improvement as per his own account. Clinical examination showed Kayser-Fleischer rings in the eyes, raised serum ceruloplasmin, and significant MRI findings. If symptoms like isolated dysarthria are encountered, a thorough work-up must be done to rule out any underlying neurological problems. The key teaching point revolves around the consanguinity of marriages in India should raise an index of suspicion for autosomal recessive conditions and movement disorders.