Lumbar puncture alleviates chorea in a patient with Huntington's disease and normal pressure hydrocephalus

A 44-year-old African-American male was admitted to our hospital after a suicide attempt. He had depression, poor cognitive function, choreiform movements, difficulty pronouncing words, and difficulty walking. His symptoms had worsened markedly over several months. Chorea lead to genetic testing tha...

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Bibliographic Details
Published in:Behavioural neurology 2009, Vol.21 (3), p.193-195
Main Authors: Shirani, Peyman, Salamone, Alicia R, Lahijani, Elham, York, Michele K, Schulz, Paul E
Format: Article
Language:English
Subjects:
Adult
Chorea - complications
Chorea - therapy
Humans
Huntington Disease - complications
Huntington Disease - therapy
Hydrocephalus, Normal Pressure - complications
Hydrocephalus, Normal Pressure - therapy
Male
Spinal Puncture
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Summary:A 44-year-old African-American male was admitted to our hospital after a suicide attempt. He had depression, poor cognitive function, choreiform movements, difficulty pronouncing words, and difficulty walking. His symptoms had worsened markedly over several months. Chorea lead to genetic testing that confirmed a diagnosis of Huntington Disease (HD). A CT scan of the head showed wider ventricles than is typical of HD. The head CT and gait change suggested normal pressure hydrocephalus (NPH). Lumbar puncture (LP) led to improved neuropsychologic test scores and walking thereby supporting the diagnosis of NPH. Surprisingly, the LP also led to an 80% improvement of chorea. There are two other reports of an association between HD and NPH. NPH should be considered in HD patients with atypical symptoms, such as the inability to walk or rapid progression, as its treatment may lead to improved cognition, gait, and chorea.
ISSN:0953-4180
1875-8584
DOI:10.1155/2009/606438