HUNTINGTON`S DISEASE Tutor`s Name

Huntington`s disease (HD) is a disorder that can be inherited and breaks down nerve cells in the brain leading to movement, cognitive and psychiatric disorders (Moscou and Snipe, 2012). Huntington`s disease is named after an American doctor, George Huntington, who was the first person to describe this condition (Quarrell, 2008) and documented the symptoms of this disease (Knowles, 2007). Normally, Huntington`s disease onset happens in the middle age and rarely occurs after age 55, but juvenile Huntington`s disease onset is associated with rapid progression of symptoms and reduced life expectancy (Moscou and Snipe, 2012). There is no cure for this disease and so the available medication assist in managing the symptoms, and treatments cannot help in stopping physical, mental and behavioral decline caused by this disease. This essay presents a very thoughtful discussion on Huntington`s disease noting its signs and symptoms, causes, risk factors, complications, tests and diagnosis, treatment and drugs, and how it can be prevented.
Huntington`s disease result in movement, cognitive as well as psychiatric disorders with various symptoms and the appearance of these symptoms vary greatly among affected individuals. Huntington noted that this disease is inherited and it leads to mental decline in addition to physical symptoms (Knowles, 2007). Arguably, the movement disorders related to HD involve involuntary movements as well as impairments in voluntary movements. Involuntary movements include chorea, dystonia (Quarrell, 2008), muscle rigidity, unusual eye movements, impaired balance, difficulty in swallowing and speech production. Accordingly, impairments in voluntary movements may interfere with an individual`s ability to carry out daily activities leaving them dependant. More so, cognitive impairments related to HD are lack of flexibility, inability to start a task or conversation, difficulty in planning, organizing and prioritizing tasks, and lack of impulse control (Moscou and Snipe, 2012). Furthermore, psychiatric disorder associated with this disease is depression which occurs due to brain damage as well as subsequent alteration of brain functions and generally, depression is determined by sadness and worthlessness, insomnia, loss of interests and strength, fatigue as well as reduced sex drive among others. Those suffering from Huntington`s disease are also at risk for suicide especially during the symptomatic stage of the disease (Gabbard, 2007). Moreover, other common psychiatric disorders include mania and bipolar disorder. However, the onset and progression of juvenile HD is slightly different from that of adults and some of the problems associated with juvenile HD include rapid drop in school performance, behavioral problems, and tremors among others. It is recommended to seek the doctor`s help when changes in movements, emotional state and mental ability are noticed.
Huntington`s disease is caused by an inherited defect in a single gene and one needs only a single copy of the detective gene in order to acquire and develop the disorder. Normally, a person acquires two copies of each gene with one copy inherited from each parent and studies reveal the possibility of a parent with a “defective Huntington gene passing on the defective copy of the gene or the healthy copy, therefore, every child in that family has a 50 percent chance of inheriting the gene that causes HD” (Moscou and Snipe, 2012). Individuals that are at risk of getting affected by HD are those that their parents have this disease as they have 50 percent chance of developing the disease (Moscou and Snipe, 2012) but it is very rare to find people developing HD when they do not have any family medical records of this disease. Complications of HD are experienced after its onset when the patient`s ability to function gets worse and can even lead to death. However, the rate at which HD progresses does vary as well as the duration of its progression with the onset of the disease to death in adults ranging between 10 to 30 years and 15 years or less for children. More so, there is high possibility of clinical depression linked with HD may increasing the risk of committing suicide before the diagnosis. Eventually, a person with HD is likely to be weak and confined to bed, and the common cause of death due to HD suffering mainly involves the complications resulting from the difficulty in swallowing.
During tests and HD diagnosis, reviewing an individual`s symptoms and other factors like the medical history of the family is essential in the assessment of the disorder. A diagnosis of HD is based primarily on the patient`s answers to the questions about medical history followed by both neurological tests as well as psychiatric tests where a neurologist is expected to ask relevant questions and perform necessary tests to determine muscle strength, balance, mental status, mood and vision and eye movement among others. Accordingly, a psychiatrist will focus on emotional state, behavior patterns, coping skills, and signs of disordered thinking. Furthermore, the doctor may request various examinations to determine the brain structure as well as its roles, for instance, brain-imaging tests is recommended in order to determine changes in the structure of the brain especially in places that have been affected by HD, and electroencephalogram (EEG) if there have been cases of seizures experienced. More so, the doctor is allowed to conduct a genetic test particularly for the presence of detective gene so as to confirm HD diagnosis. A predictive genetic examination is conducted specifically on those individuals coming from the families where this disorder has been experienced but this test reveals no symptoms, and test does not indicate when disease onset will begin.
Undoubtedly, there is no treatment that can be used to alter the onset of HD but there are some medications can help in suppress some of the symptoms of movement as well as psychiatric complications. Drugs that may be used to examine some HD symptoms can trigger some symptoms and this call for regular review and update of treatment goals and plans. Some of the drugs used to treat movement disorders include tetrabenazine to suppress chorea but this may trigger depression and other psychiatric conditions antipsychotic drugs like haloperidol and clozapine to treat chorea but may worsen other psychiatric conditions and anti-seizure medicine such as clonazepam can also be used to manage this condition (Moscou and Snipe, 2012). Moreover, medications to treat psychiatric disorders include antidepressants such as escitalopram, fluoxetine, and sertraline antipsychotic drugs to suppress violent outbursts, and mood stabilizing drugs like anticonvulsants to prevent mood swings related to bipolar disorder (Moscou and Snipe, 2012). In addition, psychotherapy, speech therapy and physical therapy and occupational therapy are necessary in managing some of the problems associated with HD and one way of preventing this disease is through genetic counseling especially if there is the history of the disorder in the family and for married partners who are planning to have children but have family records of HD.
References
Gabbard, G. O. (2007). Gabbard`s Treatments of Psychiatric Disorders. Washington, D.C: American Psychiatric Pub.
Knowles, J. (2007). Huntington`s Disease. New York: Rosen Pub. Group.
Moscou, Kathy, and Snipe Karen. (2012). Pharmacology for Pharmacy Technicians Pageburst E-Book on VitalSource. Elsevier Health Sciences.
Quarrell, O. (2008). Huntington`s Disease. Oxford: Oxford University Press.

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