Case 421

Enunciado

Male patient, 27 years old, healthy until about 4 years ago, when started some involuntary movements in the upper limbs, progressing to the lower limbs. His family observed obsessive behavior towards virtual pornography, in addition to frequent falls and imbalance. He presented progressive motor difficulty, inappetence and weight loss. On physical examination, there was motor impersistence of the tongue, dysarthria, bizarre gait, gestural apraxia, vocal tics and chorea.

Image 1: Computed tomography of the skull in axial section without contrast, ate the level of the basal ganglia.

Image 2: Computed tomography of the skull in axial section, without contrast, ate the level of the lateral ventricles.


Image 3: Genogram with four generations of the family. Patient indicated by the red arrow.



Question:
Based on the clinical history and the images presented, what is the probable diagnosis of the patient?

Questão de Prova

(Prerequisite in Neurology, FGO – 2018)

Huntington's disease is a progressive disease comprising abnormal movements, dementia and psychiatric manifestations. From the point of view of genetic, pathophysiological and molecular aspects, it is characterized by being: