Anaesthetic management in Wilson's disease with severe neuropsychiatric manifestations

A 15 year-old girl presented with acute psychosis, seizures and right shoulder dislocation with an overlying abscess. The symptomatology was diagnosed to be due to Wilson’s disease. The anaesthetic management and postoperative analgesia was a challenging task in presence of hepatic and acute neurological dysfunction as well as difficulty in pain assessment. There are only a few reported cases of anaesthetic management in patients with Wilson’s disease with severe neuropsychiatric symptoms. This case portrays the safe use of both general and regional anaesthesia in such a patient.