Huntington chorea presenting with motor neuron disease.

BACKGROUND

There have been a few case reports of motor neuron disease in association with Huntington disease (HD).

OBJECTIVE

To describe a patient presenting with prominent fasciculations, chorea, and possible amyotrophic lateral sclerosis (ALS) in whom genetic testing revealed HD mutation.

DESIGN

Case report.

SETTING

University of Texas Southwestern Medical Center, Dallas. Patient  A 69-year-old man with chorea and fasciculations.

INTERVENTIONS

Genetic and electrophysiologic testing.

MAIN OUTCOME MEASURES

Genetic test result, electrophysiologic test result, and physical examination.

RESULTS

A 69-year-old man with long-standing depression and failing memory presented with muscle twitches of 8 months' duration. He was found to have choreoathetoid movements and distal weakness on neurological examination. Electrophysiologic studies revealed evidence of motor neuron disease. Genetic test showed CAG repeat of 40 on chromosome 4, confirming the diagnosis of HD.

CONCLUSION

Motor neuron disease can rarely occur in patients with HD and could be one of its presenting features.