Huntington's disease remains a devastating disease for patients and their families. Here we try to address all useful aspects to improve patient management: diagnosis, assessment and treatment, diverse assistances and finally some notions about treatments being tested in clinical trials. Previous Article Editorial Board. Journal page Archives Contents list. Brunaud-Danel, C.
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Huntington's disease is a neurodegenerative genetic, autosomal dominant disease. George Huntington describes this trouble in The main symptoms are: choreic movements, axial impairment, psychiatric disorders and the presence of cognitive impairment. The diagnostic is clinic, genetic and radiologic. Despite the absence of curative treatment, symptomatic care supports deficit symptoms of the pathology, thus improves the quality of life of patients.
We will define diagnostic and clinical aspects of Huntington's disease, and then we will focus our analysis on the psychiatric aspect. First, we will illustrate management provided by our teams. They give tetrabenazine and to prevent depressive effect we prescribed antidepressant first serotonin—norepinephrine reuptake inhibitor , then antipsychotic risperidone, then haloperidol and benzodiazepine.
She was admitted in psychiatric unit for psychotic symptom. She received antipsychotic risperidone and antidepressant venlafaxine with benzodiazepine. Both of them had clinical improvement. Benzodiazepine had good result for anxiety. We must search and treat psychiatric disorder like depression and mood disorder. Irritability and anxiety are symptoms of mood disorder and can be treated with antidepressive and mood stabilizer. Suicide is an emergency because of the mortality rate. The guideline is the same of suicide in psychiatric emergency.
Antipsychotics are not avoided and used for choreic and psychotic symptoms delirium, hallucination… but second generation antipsychotics are generally preferable because of the lesser presence of adverse event. The use of selective serotonin reuptake inhibitors SSRIs and serotonin—norepinephrine reuptake inhibitor SNRI for moods sign are the most frequently used therapy reference.
Electroconvulsive therapy ECT and mood stabilizer have similar results to those obtained in mood disorders without neurodegenerative pathology. Antipsychotic like risperidone or olanzapine are good requirements. Guidelines of Huntington's disease national reference center and literature give these therapeutic choices. With our two patients, we can see clinical improvement and the main objective was return home.
Literature explain important role of psychotherapy, social, diet and hygiene habits. We must have global care like other psychiatric patient and more because of neurological reach.
The implementation of classical specific therapeutic in psychiatry improves these symptoms and optimizes the quality of life for our patients. A comprehensive and multidisciplinary support involving medical and paramedical rehabilitation is a necessity to take into account.
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Huntington disease is a progressive brain disorder that causes uncontrolled movements, emotional problems, and loss of thinking ability cognition. Adult-onset Huntington disease , the most common form of this disorder, usually appears in a person's thirties or forties. Early signs and symptoms can include irritability, depression , small involuntary movements, poor coordination, and trouble learning new information or making decisions. Many people with Huntington disease develop involuntary jerking or twitching movements known as chorea. As the disease progresses, these movements become more pronounced. Affected individuals may have trouble walking, speaking, and swallowing.
Terrenoire Gwen. Gwen Ter renoire: Predictive medicine, the test of experience: presymptomatic diagnosis of Huntington's Chorea. In the last few years medical genetics has begun experimenting a new way of preventing certain late-onset hereditary diseases by using techniques that enable a prediction to be made many years before the first clinical symptoms appear. Most observers of this new predictive medicine have focussed on the risks of social discrimination which it may entail for at-risk persons. This article offers another approach to the question of risks by studying the principles at the heart of one testing procedure, the presymptomatic screening programme for Huntington's disease, and comparing them with the actual experience of the subjects involved in this experiment. The tension observed in the course of testing between the organizers of the programme and the subjects points to two fundamentally different positions with respect to the test and the disease. XI, nos , octobre
Huntington's disease HD , also known as Huntington's chorea , is an inherited disorder that results in the death of brain cells. There is no cure for HD. The first likely description of the disease was in by American physician Charles Oscar Waters. The most characteristic initial physical symptoms are jerky, random, and uncontrollable movements called chorea. Common consequences are physical instability, abnormal facial expression, and difficulties chewing, swallowing , and speaking.