Juvenile Huntington's disease presenting as difficult-to-treat seizure and the first episode of psychosis

Abstract

ObjectiveThe objective was to describe a case of juvenile Huntington's disease that first presented with seizures and psychosis. MethodsA male patient with no history of epilepsy and psychiatric disorder had his first seizure at the age of 20 years, which was followed by 3 years of psychotic disorder. ResultsLaboratory investigations were normal, and mild diffuse cortical atrophy was detected using magnetic resonance imaging. Both the seizures and psychosis were difficult to treat. Three years later, chorea and personality changes appeared. Genetic tests revealed an expanded allele with 60 CAG repeats, confirming the typical Huntington's disease characteristic. ConclusionPatients with difficult-to-treat seizures and the first episode of psychosis should be considered for the diagnosis of juvenile Huntington's disease.