Snapshot A 33-year-old female is referred to a neurologist by her primary care physician for unsteady gait, forgetfullness, and recent episodes of Terret-like spells where she will fling one arm out and above her head seemingly unprovoked. On physical exam, the neurologist notices that her irises appear multicolored with concentric rings around the perpiphery. He is concerned for a metabolic disease and orders several laboratory and radiologic studies. In the interim he has advised her to avoid eating chocolate and shellfish. Introduction Free copper accumulation in many tissues (liver, brain, cornea, joints) login to view 9 more bullets Presentation Symptoms login to view 6 more bullets Physical exam login to view 4 more bullets Evaluation Labs login to view 5 more bullets Liver Biopsy login to view 1 more bullet Treatment Medical login to view 8 more bullets Surgical login to view 1 more bullet Prognosis, Prevention, and Complications At risk for liver disease login to view 3 more bullets Also at risk for Fanconi's disease of the proximal tubules