Introduction
Huntington's disease is a hereditary neurodegenerative disorder impacting cognitive and motor functions. It is caused by a mutated gene affecting brain cells' communication, leading to involuntary movements, cognitive decline, and psychiatric symptoms. Symptoms typically appear in mid-adulthood and worsen over time, profoundly affecting the quality of life.
What Is Huntington’s Disease?
It is a degenerative condition of nerves, where certain parts of the brain lose their function over time. Huntington's disease causes a marked decline in the individual's physical, emotional, and cognitive abilities over the years. It is a genetically inherited disease usually passed on from the parents directly to children. Along with physical impairment, the affected individual tends to suffer a great deal of psychological and emotional problems during the course of the disease. Huntington’s disease worsens gradually to grow fatal over fifteen to twenty years from birth, to the point the individual requires full-time nursing assistance.
What Causes Huntington’s Disease?
It is caused by a faulty gene inherited from one’s parents. Huntington's disease belongs to the autosomal dominant category, which means there is about a fifty percent chance of inheriting this condition if one of the parents is affected. These genes cause irreversible damage to the nerve cells and gradually reduce their number. This affects the functions of the brain and spinal cord in an individual.
What Are the Symptoms of Huntington’s Disease?
Not everyone affected with Huntington’s disease shows the same type of symptoms, nor do they appear at the same stage of the disease. Usually, the symptoms do not start in childhood but later on in life, around the ages of thirty to fifty. Here is a list of what symptoms to expect at each stage of the disease:
Early-Stage Huntington’s Disease:
In the early stages of the disease, individuals show all or one of the following symptoms:
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Uncontrollable jerky movements (chorea) of hands and legs - The individual makes involuntary movements they do not intend to make, which may be socially awkward.
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Slurred speech and issues with swallowing.
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Clumsiness and difficulty in moving around - one finds it difficult to execute a set of movements one wants to make, such as turning the pages of a book, buttoning up a shirt, or driving.
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Stumbling while walking.
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Mental depression, obsessions, and anxiety.
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Altered personality, always prone to mood swings - show irritability, anger, and frustration.
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Inability to focus on matters that require planning and organizing.
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Difficulty in adapting to new situations.
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One tends to be frequently forgetful.
Middle-Stage Huntington’s Disease:
Symptoms at this stage have a lot to do with muscle function and body movements. One may suffer:
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Stiffness and rigidity in the muscles with uncontrollable muscle spasms.
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Movements tend to slow down drastically as arms and legs get clumsier than before.
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Forming words becomes difficult while speaking.
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Finds it hard to swallow food, making eating altogether difficult, leading to excessive weight loss.
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Those who had an onset of symptoms in their teens suffer high-level behavioral challenges. One shows frequent bouts of intense frustration, depression, and anger; this can be very challenging for the affected and their close ones.
Advanced Stages of Huntington’s Disease:
As per the features of this condition, in the later stages of Huntington’s disease, one’s general health and functional abilities decline to a minimum. Towards this stage, one suffers:
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Severe weight loss for being unable to eat and swallow.
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Nutritional deficiencies as a result of problems with swallowing.
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Movement gets severely restricted due to the extreme stiffness of the body.
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Speech and communication are severely affected.
What Is Juvenile Huntington’s Disease?
Also known as juvenile-onset Huntington's, where one develops the symptoms before the age of 20 years. Though juvenile Huntington's disease is quite rare, the apparent symptoms are very different from adult Huntington's disease. The rigidity and muscular spasms start early, but the uncontrollable jerky movements (chorea) may not be there. The individual may develop seizures. In addition, most affected teenagers show behavioral problems that are difficult to manage, like mood swings, agitation, and frustration. Children tend to perform poorly at school and require specialized teachers and equipment assistance.
How Is Huntington’s Disease Tested and Diagnosed?
Diagnosis is through clinical examination, family history, and a thorough assessment of symptoms. The doctor may run various neurophysiological tests to confirm Huntington's disease. A genetic test to detect the presence of a faulty gene is confirmatory. Imaging studies help assess the level of nerve destruction. The doctor may order an electroencephalogram (EEG) to determine the brain's ability to send electrical signals.
What Is the Treatment for Huntington’s Disease?
There is no set cure for Huntington’s disease, but one can learn to take care of the symptoms, effectively improving their quality of life. Treatment and support for every affected individual need to be tailored to one’s disabilities. As symptoms reach the next stage, the level and type of care should also be modified accordingly. The support system should be designed so that priority is given to the symptoms causing emotional and practical difficulty to the affected individual and their family. The following strategies are found helpful:
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Consulting a neurologist and psychiatrist to manage the behavioral aggression and ease out the uncontrolled fidgety movements. Drugs such as Haloperidol, Tetrabenazine, and Amantadine are found helpful.
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Physical Therapy- Helps ease body stiffness and maintain the range of movement to a certain extent. Therapy involves exercises, massages, and lifestyle advice.
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Occupational Therapy - The therapist can train the individual to move around better and carry out the activities of daily living in the best possible manner. Additionally, they can help the individual adapt to declining body functions with the aid of special equipment, mobility support, and other practical solutions.
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Speech and Language Therapy - Helps maintain the level of speech and improve the swallowing ability to a certain extent. They can also introduce means to improve the difficulties with eating, drinking, swallowing, and communication.
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Dieticians and Nutritionists - Can support the affected to maintain adequate body weight and remain healthy. When the eating process turns difficult, they advise high-calorie diet patterns to compensate for it.
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Genetic Counseling and Genetic Tests - Can identify the presence of the gene that is responsible for causing Huntington’s disease. Such tests help one plan their life accordingly or do the needful to prevent passing it on to the next generations in the family.
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Support Groups - Joining support groups involving other affected individuals and their families can help them figure out the best possible ways to alleviate the burden of the disease.
Conclusion:
As each stage passes, it can be highly frustrating for the individual not to be able to do the things that they did earlier in life. This brings about a lot of emotional stress and requires external support to cope with the new situation mentally. Therefore, giving the right amount of support at each stage of Huntington's disease positively improves the quality of life for the affected. Under the efficient guidance of a team of healthcare professionals, the affected one’s family may be able to come up with the best possible arrangement for rehabilitation.