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Delineating the neuropsychiatric pattern and features of Wilson disease is essential step to better recognition and management of these presentations. To our knowledge this is the first large study of neuropsychiatric manifestations of Wilson disease in Sudan. A comprehensive case finding survey was conducted over a six month period, in the Capital of Sudan, covering all secondary and tertiary services that cater for patients with Wilson disease. Patients’ assessment was carried out using batteries of functional tests, including, ICD10 research criteria for major psychiatric categories, Mini Mental State Examination, ADHD scale, school records, parental reports. All neurological findings were conducted and verified by two neurologists. Neuropsychiatric symptoms and disorders are highly prevalent in Wilson disease patients regardless of age, or stage of illness. Even though, patients in our sample had had an average of 6 years follow up duration, non-had shown evidence of liver failure. This shows an early indication of possibly benign trajectory course of the illness in Sudan