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HUNTINGTON DISEASE TREATMENTS |
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There is no cure for Huntington's disease, nor any
treatment that can slow the rate of progression. Treatment is aimed
at reducing the disability caused by the motor impairments, and
treating behavioral and emotional symptoms. Physical therapy is used to maintain strength and compensate for lost strength and balance. Stretching and range of motion exercises help minimize contracture, or muscle shortening, a result of weakness and disuse. The physical therapist also advises on the use of mobility aids such as walkers or wheelchairs. Motor symptoms may be treated with drugs, although some studies suggest that anti-chorea treatment rarely improves function. Chorea can be suppressed with drugs that deplete dopamine, an important brain chemical regulating movement. As Huntington's disease progresses, natural dopamine levels fall, leading to loss of chorea and an increase in rigidity and movement slowness. Treatment with L-dopa (which resupplies dopamine) may help here. Frequent reassessment of the effectiveness and appropriateness of any drug therapy is necessary. Occupational therapy is used to design compensatory strategies for lost abilities in the activities of daily living, such as eating, dressing, and grooming. The occupational therapist advises on modifications to the home that improve safety, accessibility, and comfort. Difficulty swallowing may be lessened by preparation of softer foods, blending food in an electric blender, and taking care to eat slowly and carefully. Use of a straw for all liquids can help. The potential for choking on food is a concern, especially late in the disease progression. Caregivers should learn the use of the Heimlich maneuver. In addition, passage of food into the airways increases the risk for pneumonia. A gastric feeding tube may be needed, if swallowing becomes too difficult or dangerous. Speech difficulties may be partially compensated for through use of picture boards or other augmentative communication devices. Loss of cognitive ability affects both speech production and understanding. A speech-language pathologist can work with the family to develop simplified and more directed communication strategies, including speaking slowly, using simple words, and repeating sentences exactly. Early behavioral changes, including depression and anxiety, may respond to drug therapy. Maintaining a calm, familiar, and secure environment is useful as the disease progresses. Support groups for both patients and caregivers form an important part of treatment. Information on local support groups is available from the Huntington's Disease Society of America. Experimental transplant of fetal brain tissue has been attempted in a few Huntington's disease patients. Early results show some promise, but further trials are needed to establish the effectiveness of this treatment. |
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| HUNTINGTON DISEASE RELATED ITEMS | ||
