Awareness of Involuntary Movements in Huntington Disease

Open Access
Publisher Website
Google Scholar
Abstract
PATIENTS WITH Huntington disease (HD) rarely complain of their involuntary movements. Although the phenomenon is well recognized clinically, its basis has not been systematically investigated. A common implicit assumption is that lack of awareness of movement disorder is one manifestation of a general reduction in insight as a result of patients' accompanying dementia. Such an interpretation is feasible given the nature of cognitive changes in patients with HD. It is well established that patients exhibit impairments in regulatory, control functions, akin to those associated with frontal lobe lesions,1 and that such lesions are commonly associated with impaired insight. An alternative common assumption is that patients' failure to acknowledge motor symptoms results from a denial of illness and represents a psychological defense against the onslaught of a distressing and debilitating disease. A third, more prosaic, explanation is also possible. Patients may fail to report involuntary movements for the simple reason that they do not experience moving abnormally. Patients may not receive internal feedback about the movement of their limbs that would lead to the subjective experience of involuntary movement.

This publication has 3 references indexed in Scilit: