Psychiatria pre prax 3/2017

Treatment of movement impairment in Huntington’s disease

Huntington’s disease (HD) is the autosomal dominantly inherited progressive neurodegenerative disease. The clinical picture of HD is characterized by motor symptoms, behavioral changes and cognitive decline. The medication of HD is purely symptomatic, no causative or disease-modifying therapies are available. The degree of choreatic dyskinesias can be ameliorated by antagonists of postsynaptic dopamine receptors - antipsychotics (tiapride, risperidone, haloperidol etc.) or depletors of dopamine (tetrabenazine). Dystonic posturing could be improved by amantadine. In rare juvenile cases with dominant rigidity and akinesia amantadine or levodopa could be effective. Side effects, such as sedation, the negative impact on voluntary movements, cognitive functioning and quality of life, should always be taken into account, assessed and carefully monitored. The authors provide personal experiences with the treatment of motor impairment in HD.

Keywords: Huntington’s disease, chorea, dyskinesia, postural instability, tiapride, risperidone, haloperidol, tetrabenazine, amantadine