Off label use of lithium in the treatment of Huntington's disease: A case series
Mrs. A, a 48-year-old homemaker, presented in 2008 with a three-year history of involuntary movements of the trunk and the hands, which had worsened over the previous 7-8 months. She had predominantly choreic movements of both upper limbs. She also had behavioral changes such as irritability and aggression of recent onset. Family history was not available. On examination, ocular saccades were slow; she had generalized choreiform movements involving hands legs, lips and the trunk; dystonia of hands and feet and ataxic gait. MRI showed caudate atrophy. Neuropsychological assessment showed diffuse fronto-parietal and temporal involvement. A genetic analysis for Huntington's disease was performed after obtaining written informed consent which showed CAG repeat expansion. Patient was started on Lithium 150 mg, once daily, along with Carbamazepine 200 mg twice a day.\nThe movements have not worsened after starting Lithium and the behavioral symptoms improved completely. Patient is on regular follow up for the last four years and is maintaining the same improvement.