Neurology: Huntington's Disease (HD)

Types of Huntington's disease

• Adult-onset: This is the most common type. Symptoms usually start after age 30.
• Early-onset (juvenile Huntington's disease): This rare type affects children and teenagers. Symptoms appear before age 20.

Symptoms and Causes

Signs and symptoms usually start slowly and get worse over time. One of the first signs is chorea. This is a jerky or twisting movement you can't control. Chorea often begins in your hands, fingers or face. It then spreads to your arms, legs and body. This movement can make it hard to speak, eat or walk.

• Problems swallowing or slurred speech
• Stiff or slow movements
• Trouble focusing your eyes
• Trouble with balance or coordination
• Unexplained weight loss
• Acting on impulse or using poor judgment
• Anxiety
• Difficulty planning or making decisions
• Not noticing changes in yourself
• Feeling sad, hopeless or unmotivated
• Mood swings, anger or irritability
• Trouble concentrating or remembering things

Juvenile Huntington's disease symptoms

Teens may also develop chorea and emotional changes similar to adult Huntington's disease. As time goes on, movement and thinking problems usually become more noticeable.

• Changes in mood, like irritability or depression
• Clumsiness or balance problems
• Delayed speech or trouble talking clearly
• Muscle spasms or unusual body positions
• Trouble at school, like learning problems or lower grades

How is Huntington's disease diagnosed?

• Medications
• Supportive care
• Clinical trials
• Antidepressants (like SSRIs) to manage depression and anxiety
• Antipsychotic medications (like olanzapine, risperidone, quetiapine or aripiprazole), which may calm mood swings
• Mood stabilizers to reduce impulsivity, aggression, irritability or other behavior changes.