Presentation
They did not present with typical chorea as seen in adult onset Huntington disease. There was a predominance of rigidity and bradykinesia. [ncbi.nlm.nih.gov]
This juvenile HD is characterized by a larger number of CAG repeats typically exceeding 60, and often presented with spasticity, rigidity and seizures unlike adult-onset choreic form. 2 We report a case of unusual juvenile HD presenting with seizures [e-jmd.org]
Entire Body System
- Movement Disorder
Each new patient at the UAB Movement Disorders Clinic is evaluated for inclusion in these ongoing trials. [uabmedicine.org]
Our findings reinforce the hypothesis that clinical manifestations, other than the typical movement disorder, may anticipate age at onset of even many years. [ncbi.nlm.nih.gov]
A case report of juvenile Huntington disease Abstract Huntington disease (HD) is a progressive neurodegenerative disorder, characterized by autosomal dominant inheritance, movement disorder, dementia, and behavioural disturbances. [jpnim.com]
Juvenile HD is characterised by a movement disorder, which differs from that of affected adults. [huntingtonswa.org.au]
There may also be other movement disorders - eg, tics and myoclonus. [patient.info]
- Weakness
Disordered movements, weakness, or motor impersistence in any one of the speech subsystems can result in dysarthria. Click here to view video Respiration Respiration may be perceptually deviant in chorea. [movementdisorders.org]
'I just thought he was being awkward' Later, they develop physical problems such as the shakes or nervous tics, then weight loss and muscle weakness which leaves the patient unable to swallow, speak or move. [dailymail.co.uk]
HD patients become very weak and as their immune systems suffer, which results in many people eventually developing illnesses like pneumonia or heart complications. [draxe.com]
The very low prevalence rates among blacks in South Africa (0.02, 95% CI 0-0.5 per 100,000) [ 19 ] and Zimbabwe (1.00, 95% CI 0.48-1.84 per 100,000) [ 20 ] may be due to weak case ascertainment in communities with limited healthcare provision. [karger.com]
Unlike Parkinson disease, corticospinal tract lesions cause Paresis (weakness or paralysis), preferentially in distal antigravity muscles Hyperreflexia Extensor plantar responses (Babinski sign) Spasticity that increases muscle tone in proportion to the [merckmanuals.com]
- Difficulty Walking
Physical symptoms are much more likely to raise alarm bells first, and can include: Clumsiness, or difficulty walking or balancing Rigidness in early stages of the disease, with much less involuntary movements Epileptic seizures Issues with chewing and [info.isabelhealthcare.com]
Chorea may lead to difficulty walking, speaking and swallowing. People often lose weight because of difficulty eating and by burning more calories due to the continuous movement. [global.ihi.com]
[…] such as pneumonia Incontinence and other urinary tract problems (e.g., infections) Falls and difficulty walking requiring the use of assist devices such as wheelchairs Children with juvenile-onset HD have rigidity, slow movements, and tremors that are [labtestsonline.org]
Symptoms may appear at any age and include uncontrolled movements, clumsiness, balance problems, difficulty walking, talking, or swallowing. [icd10data.com]
These are: Physical, movement-related signs and symptoms: Sudden bursts of involuntary spasms with jerking arms, legs, and body movement (termed as chorea) Muscle rigidity, contraction, difficulty walking, maintaining balance, performing basic and routine [dovemed.com]
- Fatigue
MORE: 8 Diseases That Have Fatigue As The Main Symptom There are treatments available to help with the physical and emotional symptoms. Those include drugs and physical therapy. [prevention.com]
Signs and symptoms may include: Feelings of irritability, sadness or apathy Social withdrawal Insomnia Fatigue and loss of energy Frequent thoughts of death, dying or suicide Other common psychiatric disorders include: Obsessive-compulsive disorder, a [mayoclinic.org]
Rigidity and hypokinesia may contribute to muscle aches and sensations of fatigue. The face becomes masklike (hypomimic), with an open mouth and reduced blinking. Excessive drooling (sialorrhea) may contribute to disability. [merckmanuals.com]
One of the downsides to the conventional treatment for Huntington’s disease and other cognitive disorders is that they commonly have a lot of side effects, such as fatigue, insomnia, appetite and mood changes, etc. ( 6 ) 6 Natural Ways to Manage Huntington [draxe.com]
- Surgical Procedure
Consider surgical procedures, such as deep brain stimulation, if patients have symptoms refractory to optimal drug therapy and do not have cognitive impairment or a psychiatric disorder. [merckmanuals.com]
This form of skin infection is difficult to treat with antibiotics alone and typically requires a surgical procedure to remove the involved sweat glands in order to stop the skin inflammation. [queensnaturalmarket.com]
Gastrointestinal
- Dysphagia
Effect of citric acid and citric acid-sucrose mixtures on swallowing in neurogenic oropharyngeal dysphagia. Dysphagia. 2003;18(4):231-41. http://doi.org/bkmxkt. Clavé P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M. [revistas.unal.edu.co]
Dysphagia in Huntington's disease. Archives of Neurology. 1975; 42:57-60. Hamakawa, S, Koda, C, Umeno, H, et al. Oropharyngeal dysphagia in a case of Huntington's disease. Auris Nasus Laryn. 2004; 31:171-176. Kagel, MC, Leopold, NA. [movementdisorders.org]
In agreement with previous study, additional symptoms and signs that developed during the course of the disease were dystonia, spasticity, chorea and dysphagia. 7 Chorea is very uncommon as a presenting symptom in juvenile HD, but may occur during the [e-jmd.org]
Dysarthria, dysphagia and abnormal eye movements are common. There may also be other movement disorders - eg, tics and myoclonus. [patient.info]
[…] changes Change in personal hygiene and habits Unusually anxious behaviour Irritability and aggression Depression, particularly in later stages Paranoia Dementia A number of complications can arise in late-stage HD, including: Difficulty swallowing (dysphagia [labtestsonline.org]
Psychiatrical
- Social Isolation
Psychiatric and cognitive problems can lead to social isolation and deep depression. Publication Review By: Stanley J. Swierzewski, III, M.D. Published: 31 Dec 1999 Last Modified: 22 Sep 2015 [healthcommunities.com]
Psychiatric and cognitive problems can lead to social isolation and deep depression. [augusta.edu]
- Stereotyped Behavior
REM sleep behavior disorder Rapid eye movement (REM) sleep behavior disorder Parasomnias are undesirable behaviors that occur during entry into sleep, during sleep, or during arousal from sleep. Diagnosis is clinical. [merckmanuals.com]
Neurologic
- Ataxia
Two other important clinical features were seizures and ataxia, which related with the imaging findings of early cortical atrophy and cerebellum volume loss. [ncbi.nlm.nih.gov]
However, the emergence and slow progression of other symptoms such as dysarthria, saccadic eye movements, tremors, and ataxia leading to a loss of free ambulation were also observed. [thieme-connect.com]
G11.0 Congenital nonprogressive ataxia G11.1 Early-onset cerebellar ataxia G11.2 Late-onset cerebellar ataxia G11.3 Cerebellar ataxia with defective DNA repair G11.4 Hereditary spastic paraplegia G11.8 Other hereditary ataxias G11.9 Hereditary ataxia [icd10data.com]
The juvenile variant has a more fulminant course including SEIZURES; ATAXIA; dementia; and chorea. [ebi.ac.uk]
- Behavior Problem
This can cause a number of behavioral problems with the children. Talk With a Doctor If you notice any of these types of changes in yourself or in a loved one, it is important to make sure you contact a doctor to be checked out as soon as possible. [rscdiagnosticservices.com]
Problems that often present early in the course of the disease include: Behavioral changes Difficulty paying attention Rapid, significant drop in overall school performance Behavioral problems Physical changes Contracted and rigid muscles that affect [mayoclinic.org]
They have cognitive and behavioral problems. Children as young as two-years-old have been diagnosed with the disease. Only two drugs have been FDA approved for the syndrome—and they only treat one of the symptoms. [globalgenes.org]
Medications are also available to help with seizures, as well as behavioral or psychiatric problems such as attention deficit or depression. [rarediseases.info.nih.gov]
insanity Children and juveniles may suffer from: Academic disorientation, poor performance at regular school activities (both at sports, or exams); gradual memory loss, loss of previously acquired/learned skills Behavioral problems, mood swings Mild [dovemed.com]
- Forgetful
Symptoms of Huntington’s Disease, which usually appear between the ages of 30 and 50, include: Chorea (involuntary movements) and unsteady gait Personality changes, mood swings, depression Impaired judgement, forgetfulness Slurred speech Difficulty swallowing [sitrinneurocare.com]
A 20 year girl was in good health till the age of 12 years when she developed poor school performance and started forgetting whatever she had read few days back. [neurologyindia.com]
Ability to recall information, process thoughts, and “find” the right words diminishes so people with HD may appear forgetful. Learning new information becomes increasingly difficult. [qunomedical.com]
Depression is common for HD patients, who also suffer forgetfulness, slurred speech, difficulty swallowing, loss of coordination and more. Suicide rates are estimated at five to 10 times the rate of the typical population. There is no cure. [insidecolumbia.net]
Initially, the symptoms of HD are subtle with mild cognitive changes including memory decline and forgetfulness; behavioural changes including depression, irritability, impulsiveness, and apathy; and motor changes including minor difficulties in coordination [jnnp.bmj.com]
- Agitation
[…] and skeletal muscle wasting. [ 5 ] HD is associated with increasing depression, bradykinesia, cognitive impairment and aggression as the disease progresses. [ 8 ] Behavioural difficulties include apathy or lack of initiative, dysphoria, irritability, agitation [patient.info]
Thus they may be misinterpreted as agitation or nervousness. [dovepress.com]
Antipsychotic are not the drugs of choice for obsessive compulsive symptoms, but are often added if this symptom causes agitation. [help4hd.org]
[…] appetite Mental and emotional quality-related signs and symptoms: Progressive deterioration of the senses, memory loss, communication difficulties, unable to plan or organize Changes in overall personality; regression or absence of reasoning/rationale, agitation [dovemed.com]
- Cognitive Disorder
Huntington's disease has a wide impact on a person's functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders. [mayoclinic.org]
Cognitive Training Setting up a clear schedule, following a routine and practicing reminders of daily life seem to be helpful when it comes to managing cognitive and psychiatric disorders. [draxe.com]
Heredodegenerative Disorders, Nervous System Neurodegenerative Diseases Genetic Diseases, Inborn Cognition Disorders Neurocognitive Disorders Mental Disorders [clinicaltrials.gov]
Summary of HD symptoms that require treatment: • Movement disorder Involuntary movements Incoordination of voluntary movements Rigidity/dystonia Oral-motor dysfunction. • Cognitive disorder Progressive cognitive dysfunction (treated by repeated testing [pediatricneurosciences.com]
Treatment
Specific treatments for the symptoms and signs of juvenile HD were analysed in detail. Those treatments prescribed more than twice for a particular patient were categorised as ‘regular’ treatments. [bmjopen.bmj.com]
The scope of the treatment survey was limited to medication interventions only and did not inquire about ancillary treatments such as physical, occupational, or speech therapy. [sciencedaily.com]
CLOSE Medical Disclaimer The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. [diseaseinfosearch.org]
We work with UAB functional neurosurgeons to coordinate treatment strategies for movement disorders, including PD, dystonia, and essential tremor. [uabmedicine.org]
Multidisciplinary approach with symptomatic treatment of specific symptoms is the current available management. Gene editing and gene silencing treatment are under trial. [jpnim.com]
Prognosis
Prognosis Recovery usually occurs within 2 to 3 months. Relapses, esp. in young women, may occur when oral contraceptives are used or during pregnancy. [medical-dictionary.thefreedictionary.com]
Treatment and prognosis No treatment is currently generally available 4. [radiopaedia.org]
In addition the development of sensitive measurements that allow earlier diagnosis are expected to provide the ideal time for the use of disease-modifying therapy, such as gene silencing. [ 13 ] Prognosis This is currently a relentlessly progressive, [patient.info]
With annual assessments and no end date, Enroll-HD has built a large and rich database of longitudinal clinical data and biospecimens that form the basis for studies developing tools and biomarkers for progression and prognosis, identifying clinically-relevant [clinicaltrials.gov]
Etiology
[…] disease gene test Susanne A Schneider, Ruth H Walker and Kailash P Bhatia Huntington's disease (HD), which is caused by a triplet-repeat expansion in the IT15 gene (also known as huntingtin or HD), accounts for about 90% of cases of chorea of genetic etiology [hdlf.org]
(Etiology) Genetic study and analysis have implicated anomalies in chromosome 4, with abnormal repetition of certain genetic material/sequence, as a primary factor for Huntington Disease The repeat sequence of DNA may vary anywhere between 36-120 times [dovemed.com]
The further investigation should be focus on the relationship between TS and HD, especially at the level of pathophysiology and genetic etiology. [bmcneurol.biomedcentral.com]
Atypical parkinsonism Secondary and Atypical Parkinsonism Secondary parkinsonism refers to a group of disorders that have features similar to those of Parkinson disease but have a different etiology. [merckmanuals.com]
Epidemiology
Conneally PM: Huntington disease: genetics and epidemiology. Am J Hum Genet 1984;36:506-526. Harper PS: The epidemiology of Huntington's disease. Hum Genet 1992;89:365-376. [karger.com]
EPIDEMIOLOGY: incidence: 5-10/100,000 (prevalance) age of onset: of patients with Huntingon's Disease 10% have onset of symptoms prior to 20 years of age 5% have onset of symptoms prior to 14 years of age 1% have onset of symptoms prior to 10 years of [endoflifecare.tripod.com]
The estimates of incidence and prevalence of juvenile HD reported here are, therefore, the first to provide population-based epidemiological data on the frequency of this condition either in the UK or worldwide. [bmjopen.bmj.com]
[…] increases in the length of a cysteine-adenosine-guanine (CAG) triplet repeat present in a gene called 'huntingtin' (HTT) located on chromosome 4p16.3. [ 2 ] There are many symptomatic treatments but no therapies that alter disease progression. [ 3 ] Epidemiology [patient.info]
Genetic Epidemiology. 4 (2): 77–85. PMID 2953646. ↑ De Braekeleer M, Hechtman P, Andermann E, and Kaplan F (April 1992). "The French Canadian Tay-Sachs disease deletion mutation: identification of probable founders". Human Genetics. 89 (1): 83–87. [wikidoc.org]
Pathophysiology
Predictive genetic testing allows for early identification of HD carriers and observational studies are increasing knowledge of the pathophysiology and natural progression of HD. [patient.info]
The further investigation should be focus on the relationship between TS and HD, especially at the level of pathophysiology and genetic etiology. [bmcneurol.biomedcentral.com]
Although our knowledge about the different pathophysiological processes that cause neuronal dysfunction and eventually lead to the specific pattern of neurodegeneration in HD has increased substantially over the last years, all attempts to establish a [dovepress.com]
Post-infantile Tay-Sachs was often mis-diagnosed as another neurological disorder, such as Friedreich ataxia.[14] Pathophysiology File:Autorecessive.svg The condition is caused by insufficient activity of an enzyme called hexosaminidase A that catalyzes [wikidoc.org]
Prevention
This may prevent a rapid deterioration of the condition, and help sustain the quality of life. Patients diagnosed with HD may live anywhere between 10-30 years following the onset of symptoms. [dovemed.com]
Additionally, studies on mice found that CBD can prevent the degeneration of the same type of brain tissue affected by HD 3. [elixinol.com]
"Screening and prevention in Tay-Sachs disease: origins, update, and impact". Advances in Genetics. 44: 253–65. [wikidoc.org]
Tea tree oil : Tea tree oil is purported to have antiseptic properties, and has been used traditionally to prevent and treat infections. [queensnaturalmarket.com]
Because there currently isn’t a proven cure or prevention method, there isn’t necessarily anything positive or preventative people can do once they find out they carry the gene or have passed it on to their offspring. [draxe.com]