Huntington’s disease is a neurological disorder that causes progressive degeneration of the nerve fibers in the brain. It is a genetically inherited condition that decreases the thinking ability, impairs movement, affects the functional ability and also causes psychiatric disorders. It also causes social, emotional and mental distress among the people suffering from Huntington’s disease.
The prevalence of Huntington’s disease is common among men and women, young and old; however, the greater incidence is reported in people above 30 or 40 years of age. It is also called juvenile Huntington's disease when the disease affects children and young adults below 21 years of age.
Huntington’s disease is not curable. It is treated by effective use of medicines and special management techniques that help in improving the condition of the individual. Thus, special care and support from healthcare providers, family and peers help in promoting a healthy lifestyle in people suffering from Huntington's disease.
Huntington’s disease affects the movement, coordination and also produces psychiatric symptoms. The symptoms may vary with the progression of the disease. This creates confusion and lacks clarity in the symptoms of the disease. Thus, the symptoms of Huntington’s disease may be misinterpreted over other psychiatric and movement disorders.
The early symptoms of Huntington’s disease include:
- Mood swings
- Peculiar behavior
- Lack of emotion
- Impaired thinking
- Decreased concentration levels
The advanced symptoms of Huntington’s disease include:
- Chocking (with fluid intake)
- Difficulty in swallowing
- Emotional outbursts
- Impaired activity of the muscles of the mouth and diaphragm
- Impaired coordination of hand and feet
- Loss of appetite
- Slurry speech
- Uncontrolled facial movements
- Weight loss
Huntington’s disease is an autosomal dominant disorder that is caused due to an inherited gene. The incidence of developing Huntington’s disease from the parent to the child is only 50%. The symptoms of Huntington’s disease may appear after 30-40 years of inheriting the defective gene. However, juvenile huntington’s disease is fatal and may cause death within ten years of the appearance of symptoms.
The diagnosis of Huntington’s disease includes physical examination, neurological examination, psychiatric examination and monitoring the family history of the individual.
The neurological examination may include the following tests:
- Motor examination: The motor examination is performed to physically monitor the balance, coordination, muscle tone and muscle reflexes.
- Sensory examination: The sensory examination may include tests to monitor the sense of touch, hearing and vision impairment.
- Psychiatric examination: The test is performed to study the mood and mental status of the individuals suffering from Huntington’s disease.
The test is performed by the psychiatrist to evaluate the mental, emotional and the behavioral patterns of the individual that may be affected due to Huntington’s disease.
Image scan such as magnetic resonance imaging (MRI) scan and computed tomography (CT) scan is performed to reveal the structural changes and the damage caused in the brain due to Huntington’s disease.
The images obtained in the early stages of the disease may not be effective in determining the intensity of damage caused to the brain. However, these image scans when performed in the advanced stage of the disease helps in effective treatment and management of the disease.
The treatment for Huntington’s disease may include medications to treat movement and psychiatric disorders. Antidepressant, antipsychotics and mood stabilizing agents are used to treat psychiatric disorders. These drugs are given in combination with other medications for effective management of Huntington’s disease.
Psychotherapy helps in improving the behavioural pattern by facilitating effective communication through talk therapy and other rehabilitative measures. Effective communication among family and peers helps in coping with psychiatric disorders. Psychotherapy should be followed with use of antipsychotic and antidepressant drugs in people suffering from advanced stage of Huntington’s disease to prevent aggression and emotional outbursts.
Physical therapy promotes physical fitness and moderate exercise that helps in controlling balance, coordination and posture, as these are affected due to Huntington’s disease. This therapy improves physical movement and promotes the individual to perform certain activities with ease.
Occupational therapy uses specialized assistive devices that help the person improve the functional abilities. For example fixing hand railing along the stairs and walls of the room promotes performing certain activities on their own.
Using special devices for eating, bathing and using the toilet helps in improving functional abilities among persons suffering from advanced Huntington’s disease.
The management of Huntington’s disease requires special care to be provided to the patient by the family, peers, caretakers and the healthcare providers. Managing the patient over a period of time gets tough as the movement and coordination are affected.
Special care should be focused on providing a nutritious diet, managing psychiatric conditions, providing assistive tools to perform daily chores and regular medical check-ups helps in managing the symptoms of Huntington’s disease.
Thus, the quality of life along with medical and psychiatric support should be emphasized for better management of people suffering from Huntington’s disease.
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