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sábado, 7 de julio de 2018

Huntington’s disease

emDocs - July 4, 2018 - By: McGurk K & Dyer S - Edited by: Koyfman A & Long B
Take Home Points
  • The clinical effects of HD are progressive but develop slowly. New or rapid changes in a patient’s motor function or cognition should prompt consideration of alternative etiologies or concurrent illness.
  • HD patients may present with acute psychiatric symptoms even before the development of motor symptoms. Risperidone is the med of choice for acute psychosis in HD.
  • Patients with HD need to be carefully screened for suicidal ideation. Their risk of suicide is significantly higher than the general population.
  • Use caution before administering succinylcholine as there may be an increased risk of prolonged apnea and muscle paralysis in this patient population. Certain medications, including anticholinergics and metoclopramide, may contribute to worsened chorea.
  • Consider awake fiberoptic intubation when appropriate. Patients with advanced HD have a high risk of aspiration.