A case of obsessive symptoms in Huntington’s disease

Abstract

Background. Recently, some authors have postulated the existence of the so-called «obsessive spectrum». This would include disorders that have the common point of the presence of repetitive thoughts and actions, which may either have a «compulsive» or «impulsive» nature. Certain neurological disorders with repetitive movements have also been grouped within this spectrum, including some forms of epilepsy, Parkinson’s disease, Sydenham's Chorea or Huntington’s disease. There is evidence that physiopathological connections may exist between some of these conditions.

Methods. A case of a patient with Huntington’s Chorea with obsessive signs and symptoms is presented. The patient is a 50 year old male, diagnosed of Huntington's Chorea who is being treated with 25 mg/day of clozapine and 10 mg/day of clorazepate. The patient refused to eat certain foods for «fear of choking». He began to display other obsessive behaviors such as refusing to touch objects that might have been touched by others, and developed ritual checking methods. Treatment based on the administration of 40 mg/day of paroxetine was begun. With this treatment the compulsive symptoms have disappeared, as has the fear of choking. However, the choreic movements typical of his condition persist and the signs and symptoms associated with a process of dementia are becoming increasingly evident.

Conclusions. It is concluded that the case described may well be a good example of obsessive spectrum, and that the underlying physio-pathology should be studied.