Huntington's Disease

Plain-language definition

Hereditary neurodegenerative disease with involuntary movements. Rehabilitation to maintain balance and independence.

Signs and points requiring attention

• Involuntary choreic movements: sudden, unpredictable, large amplitude movements affecting face, limbs and trunk. These movements worsen with stress and disappear during sleep. They are characteristic but not always present.
• Major gait and balance disorders: dancing, unstable gait with widened base of support. Falls are frequent and constitute a major cause of morbidity. Balance progressively deteriorates.
• Progressive muscle rigidity (dystonia) developing with progression: gradually replaces chorea in advanced stages. Causes abnormal postures, contractures and muscle pain.
• Progressive cognitive disorders: slowed information processing, planning and organization difficulties, attention disorders. Frequent behavioral and psychiatric disorders: irritability, apathy, depression, sometimes obsessional disorders.

• Repeated falls or injuries: need to reevaluate environment, assistive devices and rehabilitation program. Each fall increases the risk of the next.
• Significant swallowing difficulties: frequent aspiration, coughing during meals, weight loss. Vital risk of aspiration pneumonia, urgent speech therapy consultation.
• Severe behavioral disorders: aggression, disinhibition, dangerous behaviors for patient or others. Psychiatric consultation for treatment adjustment.

Assessment and care

• Intensive balance work and fall prevention: postural stabilization exercises, protective reactions, learning to get up from the floor, environment modification to secure mobility.
• Maintenance of joint mobility and muscle flexibility: stretching of dystonic muscles, passive mobilizations if necessary, prevention of contractures that limit independence.
• Coordination and motor control exercises: rhythm work, dual-task exercises (walking and talking), fine motor activities. The goal is to maintain functional capabilities as long as possible.
• Comprehensive independence support: daily living activity adaptation, selection of appropriate assistive devices, work in coordination with occupational therapist and speech therapist.

This information does not replace diagnosis or medical consultation.