Abstract
Drug or disease - Differentiating and managing motor symptoms associated with late onset Huntington’s disease from extrapyramidal side-effects of antipsychotics
Highlights
Huntington’s disease is an autosomal dominant neurodegenerative condition which is progressive in nature [1]
We present the case of a middle aged gentleman with a history of schizophrenia, abnormal movements, and severe, life threatening weight loss
Weight loss is considered to be an integral manifestation of the disease, especially in late onset cases the factors causing weight loss in patients with Huntington’s disease is not completely understood
Summary
Huntington’s disease is an autosomal dominant neurodegenerative condition which is progressive in nature [1]. The rates are significantly lower in Asia and Africa, with an estimated prevalence of 0.5 per 100,000 in East Asian countries and even lower in African countries [3] The condition affects both sexes with a mean age of onset of about 40 years. Adult onset Huntington’s disease presents around 40 years of age and has an average repeat sequence of about 44 [6]. Psychotic symptoms similar to schizophrenia are seen in about 6% to 25% of the patients [11] They are more common in juvenile onset Huntington’s disease. The abnormal movements had been mistakenly attributed to extra-pyramidal side-effects caused by his antipsychotic medication This case illustrates the challenges in the diagnosis of Huntington’s disease in patients with late onset of the condition, and those with psychiatric co-morbidities
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