The symptoms of HD vary widely from person to person, even within the same family. For some, involuntary movements may be prominent even in the early stages. For others, these may be less evident and emotional and behavioural symptoms may be more obvious. The following are common features of HD.
Depression, irritability, anxiety and apathy are often encountered in HD. Some people can experience depression for a period of months or even years before it is recognised to be an early symptom of Huntington’s. Behavioural changes may include aggressive outbursts, impulsiveness, mood swings and social withdrawal. Sexual needs are often not present or extremely big. Control of ones temper is difficult and the patient shows often a demanding behaviour. Often, existing personality traits will be exacerbated by HD, e.g. a person who had a tendency to be irritable will become more irritable. Schizophrenia and other serious psychiatric problems are uncommon in HD but do occur.
Slight intellectual changes are often the first signs of cognitive disturbance. These may involve reduced ability to organise routine matters or to cope with new situations. Short-term memory loss may occur while long-term memory stays intact. Work tasks become more difficult
Physical symptoms may initially consist of “nervous” activity, fidgeting, twitching, or excessive restlessness. Handwriting may change and facial grimaces may appear. Day-to-day skills involving coordination and concentration, such as driving, become more difficult.
These initial symptoms will gradually develop into more marked involuntary movements of the head, trunk and limbs – which often lead to problems with walking and balance.
Speech and swallowing can become impaired. Movements generally tend to increase during voluntary effort, stress or excitement and decrease during restand sleep.