Most people with Huntington's disease develop signs and symptoms in their 40s or 50-something years, but the occurrence of disease may be earlier or even later in life. If the emergence of the disease begins before age 20 years, the condition is called juvenile Huntington's disease.
Early emergence of symptoms often results in a somewhat different and more rapid disease progression. Treatment can help manage the symptoms of Huntington's disease but can not prevent a decline in physical, mental and behavior associated with disease conditions.
Symptom
Huntington's disease usually causes movement disorders, cognitive and psychiatric with a wide spectrum. The first symptoms appear varies greatly among those affected.
Movement disorders, may include movement disorders in conscious and unconscious movements:
1. Writhing or jerking unconsciously
2. Involuntary muscle contraction
3. Muscle stiffness
4. Uncoordinated movement, slow
5. Slow eye movements or abnormal
6. Impaired gait, posture and balance
7. Difficulty speaking
8. Difficulty swallowing
9. Disruption in the movement of conscious may have a greater impact on a person's ability to work, perform daily activities, and communicate.
Cognitive Disorders:
1. The difficulty of planning, setting and prioritizing tasks
2. The inability to start a task or conversation
3. Lack of flexibility, or a tendency to get stuck on the behavior, thoughts or actions
4. The lack of neural control that can lead to an explosion of action, without thinking much
5. Problems with spatial perceptions that can lead to falls or accidents
6. Lack of awareness of their own behavior and capabilities
7. Difficulty focusing on tasks for long periods
8. Slow in processing or "find" words
9. Difficulty learning new information
Mental disorders are most commonly associated with Huntington's disease is depression. Depression seems to occur because of injury to the brain and changes in brain function. Signs and symptoms include:
1. Feelings of sadness or unhappiness
2. Loss of interest in normal activities
3. Social withdrawal
4. Insomnia or excessive sleeping instead
5. Exhaustion, fatigue and loss of energy
6. Feelings of worthlessness or guilt
7. Hesitancy and decreased concentration
8. Often think about death or suicide
9. Changes in appetite
10. Decreased sex drive
Psychiatric disorders are more common include:
1. Obsessive-compulsive disorder, a condition marked by distracting thoughts and repetitive behaviors
2. Mania, causing mood improved, overactive, impulsive behavior and self-inflation
3. Bipolar disorder, or alternating episodes of depression and mania
4. Changes in mood or personality, but not specific, include: Irritability, Apathy, anxiety, and inhibition of sexual or inappropriate sexual behavior
The development of Huntington's disease in adolescents is slightly different than in adults. The problem is often posed early in the course of the disease include:
1. Loss of academic or physical ability has ever been studied before
2. Quickly drop, significant in the overall school achievement
3. Behavior problems
4. Stiff muscles that affect gait (especially in children)
5. Changes in fine motor skills that can be seen from some of the skills such as handwriting
6. Slightly shake or involuntary movements
7. Convulsions
Cause
Huntington's disease is caused by a congenital defect in a single gene. Parent with Huntington's gene could inherit faulty copies of the defective gene or a copy of a sound. Therefore, every child in families with a parent with Huntington's gene has a 50 percent chance inherit genes that cause genetic disorders.
Treatments and drugs
There is no treatment that can cope with Huntington's disease. But the drug can reduce some symptoms of movement disorders and psychosis. Various interventions can help a person adapt to the environment and its ability for some time.
Settings medication may be necessary, depending on the overall treatment goals. Medicines to treat some symptoms may lead to side effects that worsen other symptoms. Therefore, the purpose and plan of treatment should be routinely reviewed and updated.
Drugs to treat movement disorders including
1. Tetrabenazine (Xenazine) specifically approved by the Food and Drug Administration to suppress the movement of uncontrollable jerking and writhing associated with Huntington's disease (also called chorea).
Serious side effect is the risk of triggering depression or other psychiatric conditions. Other side effects that may arise are: insomnia, drowsiness, nausea and anxiety.
2. Antipsychotic drugs such as haloperidol (Haldol) and clozapine (Clozaril) has side effects that suppress the movement may be beneficial in treating chorea. However, these drugs may aggravate muscle contractions and stiffness.
3. Other drugs that help suppress chorea and rigidity of muscles, including anti-seizure medications such as clonazepam (Klonopin) and anti-anxiety drugs such as diazepam (Valium). These medications can significantly alter consciousness, but at high risk to dependence and abuse.
Drugs for psychiatric disorders
1. Antidepressants include drugs such as escitalopram (Lexapro), fluoxetine (Prozac, Sarafem) and sertraline (Zoloft). This drug can also treat obsessive-compulsive disorder. Side effects: nausea, diarrhea, insomnia, and sexual problems.
2. Antipsychotic drugs can suppress the explosion of violence, agitation and symptoms of mood disorder or psychosis.
3. Mood stabilizer medications, can help prevent mood fluctuations associated with bipolar disorder. These drugs include: lithium (Lithobid) and anticonvulsants such as valproic acid (Depakene), divalproex (Depakote) and lamotrigine (Lamictal). Common side effects are weight gain, tremors and gastrointestinal problems. Periodic blood tests are needed to use lithium because it can cause thyroid problems and kidney.
Psychotherapy
A psychotherapist or a psychologist can provide speech therapy to help manage problem behavior, develop problem-solving strategies, manage expectations during disease progression and facilitate effective communication between family members.
Speech therapy
Huntington's disease could significantly disrupt the control of the muscles of the mouth and throat are very important to talk, eat and swallow. A speech therapist can help improve the ability to speak or teach using a communication device such as a board covered with pictures of activities and objects of everyday. Therapists also can help overcome the problem of the muscles used for eating and swallowing.
Physical Therapy
A physical therapist can teach the proper and safe exercises to improve strength, flexibility, balance and coordination. This exercise can help maintain mobility as long as possible and can reduce the risk of falls.
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