Illustration from a case report in 1977 of a person with<unk>  Treatments are available to reduce the severity of some of<unk>  symptoms. For many of these treatments, evidence to confirm their effectiveness in treating symptoms of<unk>  specifically are incomplete. As the disease progresses, the ability to care for oneself declines, and carefully managed multidisciplinary caregiving becomes increasingly necessary. Although relatively few studies of exercises and therapies have shown to be helpful to rehabilitate cognitive symptoms of<unk> , some evidence shows the usefulness of physical therapy, occupational therapy, and speech therapy. Therapy Weight loss and problems in eating due to dysphagia and other muscle discoordination are common, making nutrition management increasingly important as the disease advances. Thickening agents can be added to liquids, as thicker fluids are easier and safer to swallow. Reminding the affected person to eat slowly and to take smaller pieces of food into the mouth may also be of use to prevent choking. If eating becomes too hazardous or uncomfortable, the option of using a percutaneous endoscopic gastrostomy is available. This feeding tube, permanently attached through the abdomen into the stomach, reduces the risk of aspirating food and provides better nutritional management. Assessment and management by speech-language pathologists with experience in<unk>  is recommended. People with<unk>  may see a physical therapist for noninvasive and nonmedication-based ways of managing the physical symptoms. Physical therapists may implement fall risk assessment and prevention, as well as strengthening, stretching, and cardiovascular exercises. Walking aids may be prescribed as appropriate. Physical therapists also prescribe breathing exercises and airway clearance techniques with the development of respiratory problems. Consensus guidelines on physiotherapy in<unk>  have been produced by the European<unk>  Network. Goals of early rehabilitation interventions are prevention of loss of function. Participation in rehabilitation programs during the early to middle stage of the disease may be beneficial as it translates into long-term maintenance of motor and functional performance. Rehabilitation during the late stage aims to compensate for motor and functional losses. For long-term independent management, the therapist may develop home exercise programs for appropriate people. Additionally, an increasing number of people with<unk>  are turning to palliative care, which aims to improve quality of life through the treatment of the symptoms and stress of serious illness, in addition to their other treatments. Medications Chemical structure of tetrabenazine, an approved compound for the management of chorea in<unk>  Tetrabenazine was approved in 2000 for treatment of chorea in<unk>  in the EU, and in 2008 in the US. Although other drugs had been used "off label," tetrabenazine was the first approved treatment for<unk>  in the U.S. The compound has been known since the 1950s. An alternative to tetrabenazine is amantadine but there is limited evidence for its safety and efficacy. Other drugs that help to reduce chorea include antipsychotics and benzodiazepines. Hypokinesia and rigidity, especially in juvenile cases, can be treated with antiparkinsonian drugs, and myoclonic hyperkinesia can be treated with valproic acid. Tentative evidence has found ethyl eicosapentaenoic acid to improve motor symptoms at one year. In 2017 Deutetrabenazine a heavier form of tetrabenazine medication for the treatment of chorea in<unk>  was approved by the FDA. This is marketed as Austedo, and is the first small-molecule drug to receive U.S. FDA approval. Psychiatric symptoms can be treated with medications similar to those used in the general population. Selective serotonin reuptake inhibitors and mirtazapine have been recommended for depression, while atypical antipsychotics are recommended for psychosis and behavioral problems. Specialist neuropsychiatric input is recommended as people may require long-term treatment with multiple medications in combination. Education The families of individuals, and society at large, who have inherited or are at risk of inheriting<unk>  have generations of experience of<unk>  but may be unaware of recent breakthroughs in understanding the disease, and of the availability of genetic testing. Genetic counseling benefits these individuals by updating their knowledge, seeking to dispel any unfounded beliefs that they may have, and helping them consider their future options and plans. The Patient Education Program for<unk>  has been created to help educate family members, caretakers, and those diagnosed with<unk> . Also covered is information concerning family planning choices, care management, and other considerations.
Huntington's disease
Wilson's disease
Stratton Parker syndrome
Paraneoplastic syndrome
Sandhoff disease
Lupus
X-linked dystonia parkinsonism
Benign hereditary chorea