Affiliations: Department of Neurology, Baylor College of Medicine,
Houston, TX, USA | The Methodist Hospital, Houston, TX, USA
Note: [] orresponding author: Dr. Paul Schulz, Dept Neurol, NB-302, One
Baylor Plaza, Houston, TX 77030, USA. Tel.: +1 713 798 8986; Fax: +1 713 798
8530; E-mail: pschulz@bcm.edu
Abstract: A 44-year-old African-American male was admitted to our hospital
after a suicide attempt. He had depression, poor cognitive function, choreiform
movements, difficulty pronouncing words, and difficulty walking. His symptoms
had worsened markedly over several months. Chorea lead to genetic testing that
confirmed a diagnosis of Huntington Disease (HD). A CT scan of the head showed
wider ventricles than is typical of HD. The head CT and gait change suggested
normal pressure hydrocephalus (NPH). Lumbar puncture (LP) led to improved
neuropsychologic test scores and walking thereby supporting the diagnosis of
NPH. Surprisingly, the LP also led to an 80% improvement of chorea. There are two other
reports of an association between HD and NPH. NPH should be considered in HD
patients with atypical symptoms, such as the inability to walk or rapid
progression, as its treatment may lead to improved cognition, gait, and chorea.
