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Multiple sclerosis and Huntington's disease

August 15, 2012

Huntington's Disease Youth Organization

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Multiple sclerosis and Huntington's disease

Q. Hi all, I am a 27 year old female suffering with MS with no progression or relapses.

A few years ago my 2 aunts got sick and were both diagnosed with huntingtons.

My mother then got tested and was positive but at 62 has no symptoms.

I have 2 brothers and 1 sister who wont get tested but I did and I was positive.

I needed to know because of having the MS.

My question to you is how do I know if it has started?

Antionette

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A. Dear Antionette,

There are a few points to make here.

Firstly, there is no relationship between multiple sclerosis and HD. That is, HD did not increase your risk of getting MS. You were unlucky that you got MS and happened to be gene positive for HD as a coincidence.

Secondly, MS now responds to a number of effective drugs with prevent attacks and disability and which have certainly been very helpful for my patients with this condition.

Thirdly, HD and MS behave very differently and should be easily distinguished by your neurologist. These are some of the reasons why:

  • A flare of MS tends to come on over days or hours, unlike HD which comes on very slowly over months to years.
  • MS often causes numbness, tingling & weakness and visual loss (optic neuritis). These are not symptoms of HD.
  • Chorea is incredibly rare in MS.
  • MS rarely causes mood problems or memory loss whereas these are common in HD.
  • The appearances of active MS on the MRI scan of your brain or spinal cord are not seen in HD (MRI is incredibly good at picking up active MS).

Fourthly, if your mum is gene positive at 62 but doesn’t have symptoms of HD and your aunts got symptoms at a similar age then there is a good chance that you won’t get symptoms of HD until you are much older than 27. That is, if you have neurological symptoms over then next few years then they are more likely to be due to MS.

I’d recommend that because you have 2 potential causes of neurological symptoms that your neurologist knows of your HD gene status and that you have regular check ups so that you get advice form someone who knows you well if you get any worrying symptoms,

Andrew Churchyard