Bipolar disorder in a patient with Huntington disease: a case report

We report a case of a 50-year-old female patient with Huntington disease (HD). This patient was first diagnosed with bipolar disorder and underwent treatment for several years. However, the outcome was unsatisfactory and jerky involuntary movements of the right shoulder and gait impairment with frequent falls developed, which caused her much distress. During home care visits to this patient, typical chorea in the upper limbs was observed in her elder brother. Genetic testing was conducted and this patient and her elder brother were both confirmed to have HD. Therefore, HD was diagnosed in this patient based on family history, genetic testing, and home visits. Regarding treatment, we established an interdisciplinary team to address her broad physical and psychosocial needs. Bipolar disorder symptoms progressively improved and she received holistic care for HD. To diagnose HD early, it is necessary to pay attention to patients with psychiatric disease, as psychiatric symptoms often occur before the onset of involuntary movements, and to conduct comprehensive surveys including family history and, if possible, home care visits. Holistic care of patients with HD requires the implementation of multidisciplinary management methods and suicide prevention efforts to optimize quality of life.