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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Main Authors: Peyman Shirani, Alicia R. Salamone, Elham Lahijani, Michele K. York, Paul E. Schulz
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Behavioural Neurology
Online Access:http://dx.doi.org/10.3233/BEN-2009-0239
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author Peyman Shirani
Alicia R. Salamone
Elham Lahijani
Michele K. York
Paul E. Schulz
author_facet Peyman Shirani
Alicia R. Salamone
Elham Lahijani
Michele K. York
Paul E. Schulz
author_sort Peyman Shirani
collection DOAJ
description 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.
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institution Kabale University
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publishDate 2009-01-01
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series Behavioural Neurology
spelling doaj-art-21867d1e889f4e6786b28bc1bd0d7af72025-08-20T03:54:42ZengWileyBehavioural Neurology0953-41801875-85842009-01-01213-419319510.3233/BEN-2009-0239Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure HydrocephalusPeyman Shirani0Alicia R. Salamone1Elham Lahijani2Michele K. York3Paul E. Schulz4Department of Neurology, Baylor College of Medicine, Houston, TX, USADepartment of Neurology, Baylor College of Medicine, Houston, TX, USAThe Methodist Hospital, Houston, TX, USADepartment of Neurology, Baylor College of Medicine, Houston, TX, USADepartment of Neurology, Baylor College of Medicine, Houston, TX, USAA 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.http://dx.doi.org/10.3233/BEN-2009-0239
spellingShingle Peyman Shirani
Alicia R. Salamone
Elham Lahijani
Michele K. York
Paul E. Schulz
Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus
Behavioural Neurology
title Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus
title_full Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus
title_fullStr Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus
title_full_unstemmed Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus
title_short Lumbar Puncture Alleviates Chorea in a Patient with Huntington’s Disease and Normal Pressure Hydrocephalus
title_sort lumbar puncture alleviates chorea in a patient with huntington s disease and normal pressure hydrocephalus
url http://dx.doi.org/10.3233/BEN-2009-0239
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