Huntington’s Disease appears with a progressive decline of cognitive abilities (thinking, judgment, memory), movement and behavioural disorders.
Symptoms can change a lot person-to-person, even inside the same family. For someone, involuntary movements can be prominent even in the first stages. For others, the formers are less evident than emotional and behavioural symptoms. Usually, the first symptoms appear, on the average, from 40 to 50 years.
The disease gets worse and worse, so movement and cognitive disorders worsen with the evolution of disease. The dysarthria, that appears as language slowing and disorganization, is connected to swallowing difficulty as a common symptom. The disease lasts 15-25 years after the outbreak of symptoms, but it can’t be excluded that, sometimes, its duration can be longer, up to 35-40 years.
Depression, irritability, anxiety and apathy are commons. Some people can show depression for a period of months or years, before first symptoms of disease are clear. Behavioural changes can include aggressiveness, personality changes, social isolation. Often, the old features can be increase by the disease. For example, a person who is generally irritable can become aggressive. Also, indisposition like schizophrenic disorders and other serious psychiatric problems can appear, even if they are uncommons.
Slight intellectual changes are often the first sign of cognitive disorders. These changes can involve a reduced ability to organise routine situations or even a reduction of the ability to face new situations. It is possible to have a reduction of short-term memory, whereas long-term memory keeps intact.
Motoric symptoms, as already said, could be very variables in their expressions and it isn’t always simple to recognize them. It’s possible that there’s a general motoric obstacles or rather a disorder like tic. Writing could change and facial smirks can appear. As time passes by, coordination and concentration could be involved, for example driving can become difficult. These first symptoms develop by degrees up to take on the aspect of involuntary movements of the head, trunk and limbs that cause walking and voluntary actions problems. Speech and swallowing could be compromises. Movements usually are inclined to grow during voluntary efforts, stress or excitement, whereas they reduce at rest and during the sleep.
PLEASE NOTE THAT DISEASE’S EVOLUTION AND SYMPTOMPS’ SERIOUSNESS VARY PERSON-TO-PERSON
Disease’s process can be however divided in the following mail stages:
Early stage: includes expressions like slight coordination changing, some involuntary movements, difficulty to concentrate and, frequently, depression and irritability. In this stage drugs are often efficient to improve the depressive condition and others emotional symptoms.
Middle stage: the involuntary movements (chorea) could become very evident. The staggering walk could be confused with expressions caused by abuse of alcohol or drug habit (it’s useful to carry documents showing clearly the diagnosis of Huntington’s Disease). Speech and swallowing begin to be involved. Thinking slacks. In this phase, it could be more difficult to carry out a job and to manage domestic tasks. Even in these cases, simple plans of action could help to bring frustrations down, to increase functionality and extend independence.
Advanced stage: involuntary movements intensify in range and frequency (grievous chorea) that becomes dystonia (enduring muscular contracture) and then stiffness. Difficulties in feeding capability can happen and contribute to weight loss. In these phases, affected people are completely dependent on others for everything, they can’t walk for a long time and they can lose speech capability. Even if cognitive capabilities are strictly damaged, it’s important to remember that generally the person is still aware of his condition, and able to understand the language and to keep the ability of expressing his feelings.