Multidisciplinary Care in Huntington’s Disease: Case Report

Abstract

Context: Huntington’s disease (HD) is a degenerative neurological disorder with autosomal dominant inheritance resulting from the loss of GABAergic neurons in the striatum. The prevalence of HD is 10.6 to 13.7 individuals per 100,000 in the Western population. Case report: DRO is a 57- year-old female admitted to a Long-Term Care Facility in 2018 due to the diagnosis of Huntington’s Disease (HD) four years ago. The patient presented right-side hemiplegia, choreic movements in the upper extremities, postural instability, dysarthria, visual hallucinations, behavioral changes, alert and communicative. During institutionalization, the occupational therapist, physical therapist and the speech therapist performed cognitive stimulation activities, motor physiotherapy with balance training, gait and muscle strengthening, interventions for dysarthria and dysphagia prevention. After a year, there was a disease progression with episodes of fall and deterioration of choreic movements, cognitive function and coordination; then, the physical therapist intensified motor rehabilitation and bracing in the left hand in the occupational therapy sessions due to the onset of deformities. In 2020, the patient reported stabilizing her clinical condition and continued the rehabilitation sessions. Conclusions: Physiotherapeutic interventions demonstrated improvement in muscle strength and gait in HD patients. However, the results are heterogeneous due to the morbidity and phenotypic variety of the disease. The response to occupational therapy and speech therapy lacks previous studies on this disease. Thus, the multidisciplinary therapeutic approach is indicated due to its importance in the patient’s overall assessment and prevention of comorbidities.