1. How would you describe or classify this patient’s involuntary movements?
Chorea – rapid, irregular, jerky movements, usually involving distal parts of the limbs.
Athetosis – slow, writhing, twisting movements, usually involving more proximal parts of the limbs, trunk, or neck.
If both components are present, as they are in this patient, the movements may be described as “choreoathetosis”.
2. Indicate the level(s) of the neurologic lesion in this case.
Basal nuclei and cerebral cortex
3. Indicate the structures involved by the pathologic process.
Head of the caudate nucleus (and putamen) and cerebral cortex
4. The findings in this case represent a classic neurologic syndrome. What is the name of this syndrome?
Huntington Disease
5. In general, what type of pathologic process is involved in this case?
Genetic. Autosomal dominant. Increase in the number of CAG repeats in the
coding sequence of the huntingtin gene located on the short arm of chromosome 4. This causes progressive neuronal loss and gliosis in the striatum (caudate and putamen) and cerebral cortex.
6. What diagnostic procedure(s) would you undertake at this point?
