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[The White man's burden - a case study caught between bipolar affective disorder and Huntington's disease]
K Nowidi1, R Kunisch, P Bouna-Pyrrou
1Klinik für Psychiatrie, Ludwig-Maximilians-Universität, München.
Fortschritte Der Neurologie-Psychiatrie
|April 25, 2013
Summary
This case study highlights a patient with bipolar disorder who was diagnosed with Huntington's Disease due to motor symptoms. Genetic testing and neuroimaging confirmed the diagnosis, leading to a revised treatment plan.
Area of Science:
- Neurology
- Psychiatry
- Genetics
Background:
- A 55-year-old patient with bipolar affective disorder presented with depressive symptoms and severe motor disturbances.
- Initial neurological examinations for an invalidity pension trial were inconclusive, suggesting other diagnoses were unlikely.
Observation:
- Neurological examination revealed movement disorders highly suggestive of Huntington's Disease.
- Family history indicated a potential genetic link, with the patient's mother also having bipolar affective disorder.
- Neuroimaging showed a bicaudate index of 2.4, exceeding the critical value of 1.8.
Findings:
- Genetic testing confirmed Huntington's Disease in the patient.
- Psychological testing results were atypical for patients with only bipolar affective disorder.
- The patient's mother's medical history included bipolar affective disorder, with her Huntington's Disease status being unknown.
Implications:
- This case underscores the importance of considering Huntington's Disease in patients with atypical presentations of bipolar disorder.
- Accurate diagnosis through genetic testing and neuroimaging is crucial for appropriate management.
- Treatment with Quetiapine, Citalopram, and Tiaprid stabilized mood and improved motor symptoms, suggesting a multimodal therapeutic approach.
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