A 35 year old man is referred to a psychiatrist by his GP who is concerned that he had had some memory loss. He attends with his wife who tells you that she has notice that her husband has recently become quite clumsy and quick to temper. Select the most likely diagnosis.
Exam Question Jul 2011
The young age of the man makes a diagnosis of Parkinson's, frontotemporal dementia and vascular dementia unlikely.
Both CADSIL and Huntington's tend to present in the fourth decade. CADSIL generally presents with stroke, memory impairment, migraine, and severe mood disturbances.
The manââ¬â¢s motor impairment (clumsiness), along with emotional disturbance, and memory problems all point to a diagnosis of Huntington's disease.
Exam Question Jul 2011
The young age of the man makes a diagnosis of Parkinson's, frontotemporal dementia and vascular dementia unlikely.
Both CADSIL and Huntington's tend to present in the fourth decade. CADSIL generally presents with stroke, memory impairment, migraine, and severe mood disturbances.
The manââ¬â¢s motor impairment (clumsiness), along with emotional disturbance, and memory problems all point to a diagnosis of Huntington's disease.
Huntington's disease (psychiatric and behavioural)
Huntington's disease is characterised by a triad of motor, cognitive and psychiatric symptoms.
The symptoms typically begin in the third and fourth decades but with very high numbers of CAG repeats people younger than 20 can be affected (referred to as juvenile Huntington's disease).
Psychiatric presentations of Huntington's include:-
- Depression
- Dementia
- Psychosis
- Anxiety
- Mania
- Sexual dysfunction
- Suicide
Psychiatric and behavioural manifestations of Huntington's disease. Advances in psychiatric treatment (2010), vol. 16, 168-175.
