Snapshot A 26-year-old woman presents with progressive writhing and jerking movements of the extremities, excess drooling, and multiple joint pains. Computed tomography scan was unremarkable, however, a magnetic resonance image showed hypodense basal ganglia bilaterally. Ocular exam was notable for a brown-yellow pigment that appears to be around the iris. Labs were remarkable for elevated aspartate transaminase (AST) and alanine transaminase (ALT). Introduction Clinical definition login to view 1 more bullet Genetics login to view 2 more bullets Epidemiology Usually < 30 years of age Rare ETIOLOGY Pathogenesis login to view 3 more bullets Presentation Symptoms login to view 9 more bullets Physical exam login to view 8 more bullets Studies Diagnostic testing login to view 21 more bullets Differential Autoimmune hepatitis login to view 2 more bullets Huntington disease login to view 3 more bullets Treatment Lifestyle management login to view 1 more bullet First-line login to view 6 more bullets Second-line login to view 1 more bullet Complications Liver cirrhosis and failure Death