Huntington's disease usually causes movement, cognitive and psychiatric disorders with a wide spectrum of signs and symptoms. Which symptoms appear first varies greatly among affected people. During the course of the disease, some disorders appear to be more dominant or have a greater effect on functional ability.
The movement disorders associated with Huntington's disease can include both involuntary movements and impairments in voluntary movements:
- Involuntary jerking or writhing movements (chorea)
- Involuntary, sustained contracture of muscles (dystonia)
- Muscle rigidity
- Slow, uncoordinated fine movements
- Slow or abnormal eye movements
- Impaired gait, posture and balance
- Difficulty with the physical production of speech
- Difficulty swallowing
Impairments in voluntary movements — rather than the involuntary movements — may have a greater impact on a person's ability to work, perform daily activities, communicate and remain independent.
Cognitive impairments often associated with Huntington's disease include:
- Difficulty planning, organizing and prioritizing tasks
- Inability to start a task or conversation
- Lack of flexibility, or the tendency to get stuck on a thought, behavior or action (perseveration)
- Lack of impulse control that can result in outbursts, acting without thinking and sexual promiscuity
- Problems with spatial perception that can result in falls, clumsiness or accidents
- Lack of awareness of one's own behaviors and abilities
- Difficulty focusing on a task for long periods
- Slowness in processing thoughts or "finding" words
- Difficulty in learning new information
The most common psychiatric disorder associated with Huntington's disease is depression. This isn't simply a reaction to receiving a diagnosis of Huntington's disease. Instead, depression appears to occur because of injury to the brain and subsequent changes in brain function. Signs and symptoms may include:
- Feelings of sadness or unhappiness
- Loss of interest in normal activities
- Social withdrawal
- Insomnia or excessive sleeping
- Fatigue, tiredness and loss of energy
- Feelings of worthlessness or guilt
- Indecisiveness, distractibility and decreased concentration
- Frequent thoughts of death, dying or suicide
- Changes in appetite
- Reduced sex drive
Other common psychiatric disorders include:
- Obsessive-compulsive disorder, a condition marked by recurrent, intrusive thoughts and repetitive behaviors
- Mania, which can cause elevated mood, overactivity, impulsive behavior and inflated self-esteem
- Bipolar disorder, or alternating episodes of depression and mania
Other changes in mood or personality, but not necessarily specific psychiatric disorders, may include:
- Sexual inhibition or inappropriate sexual behaviors
Symptoms of juvenile Huntington's disease
The onset and progression of Huntington's disease in younger people may be slightly different from that in adults. Problems that often present themselves early in the course of the disease include:
- Loss of previously learned academic or physical skills
- Rapid, significant drop in overall school performance
- Behavioral problems
- Contracted and rigid muscles that affect gait (especially in young children)
- Changes in fine motor skills that might be noticeable in skills such as handwriting
- Tremors or slight involuntary movements
When to see a doctor
See your doctor if you notice changes in your movements, emotional state or mental ability. The signs and symptoms of Huntington's disease can be caused by a number of different conditions. Therefore, it's important to get a prompt, thorough diagnosis.
May. 05, 2011
- Huntington's disease: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/huntington/huntington.htm. Accessed March 24, 2011.
- Rosenblatt A, et al. A physician's guide to the management of Huntington's disease. Huntington's Disease Society of America. http://www.hdsa.org/images/content/1/1/11682.pdf. Accessed March 28, 2011.
- Novak MJ, et al. Huntington's disease. British Medical Journal 2010;340:c3109.
- Depression. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/home/sec07/ch101/ch101b.html. Accessed April 4, 2011.
- Nance M. The juvenile HD handbook: A guide for families. Huntington's Disease Society of America. http://www.hdsa.org/images/content/1/1/11702.pdf. Accessed March 28, 2011.
- Paulsen JS, et al. Critical periods of suicide risk in Huntington's disease. The American Journal of Psychiatry 2005;162:725.
- Frank S, et al. Advances in the pharmacological management of Huntington's disease. Drugs 2010;70:561.
- Suchowersky O. Huntington disease: Management. http://www.uptodate.com/home/index.html. Accessed April 4, 2011.
- Katon W, et al. Initial treatment of depression in adults. http://www.uptodate.com/home/index.html. Accessed April 4, 2011.