Huntington’s Disease in a Patient Misdiagnosed asConversion Disorder

Huntington’s disease (HD) is an inherited, progressive, and neurodegenerative neuropsychiatric disorder caused by the expansionof cytosine-adenine-guanine (CAG) trinucleotide in Interested Transcript (IT) 15 gene on chromosome 4. This pathology typicallypresents in individuals aged between 30 and 50 years and the age of onset is inversely correlated with the length of the CAG repeatexpansion. It is characterized by chorea, cognitive deficits, and psychiatric symptoms. Usually the psychiatric disorders precedemotor and cognitive impairment, Major Depressive Disorder and anxiety disorders being the most common presentations. Wepresent a clinical case of a 65-year-old woman admitted to our Psychiatric Acute Unit. During the 6 years preceding the admission,the patient had clinical assessments made several times by different specialties that focused only on isolated symptoms, disregardingthe syndrome as a whole. In the course of her last admission, the patient was referred to our Neuropsychiatric Team, which madethe provisional diagnosis of late-onset Huntington’s disease, later confirmed by genetic testing. This clinical vignette highlights theimportance of a multidisciplinary approach to atypical clinical presentations and raises awareness for the relevance of investigatingcarefully motor symptoms in psychiatric patients.