Early Huntington disease as a cause of dementia in a 34 year old woman
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Psychiatr Pol 2008;42(3):383–392
Dementia is a subject of interest for both neurologists and psychiatrists. The most common causes of dementia are neurodegenerative diseases of the CNS. Alzheimer's disease is the most frequent of them, much less common are Lewy's body disease, Pick's disease, Parkinson's disease or Huntington's disease. Huntington's disease is an autosomally dominant terminal illness, that occurs in approximately 5 - 7 persons in 100 000. In 90% of the cases it begins after the age of 35, the remaining 10% is the juvenile and early form, which varies from that seen in adults. Rigidity, oral motor dysfunction, gait disorder and rapid cognitive decline are the main characteristics of the juvenile and early form. Chorea is rare or absent. The case of a young woman who developed dementia with motor and speech abnormalities is presented in this paper. Due to the great non-specifity of the symptoms she was being diagnosed for about 2 years (hospitalized 3 times in the neurology wards and 4 times in the psychiatry wards). Lack of family history disorders, no specific abnormalities in neurological examination, abundance of traumatic experiences accounted for the preliminary diagnosis of a dissociative disorder (pseudodementia). Many symptoms, such as depression, obsessive-compulsive disorder, personality and behavioural disturbances were observed in the course of the disease. Finally, after 6 years from the appearance of the first symptoms, based on the third MR of CNS, the diagnosis of the early HD was established. The genetic test confirmed it.