Correlations Between Triplet Repeat Expansion and Clinical Features in Huntington's Disease

Claes et al¹ published an interesting article in the August 1995 Archives. They used a list of symptoms to screen the medical records of patients with Huntington's disease (HD) to document the clinical symptoms and correlate them with the (CAG) trinucleotide repeat length. However, they did not consider the presence of epilepsy in their patients.

Epilepsy, although rare in adult patients, is found in a considerable percentage (to 40%) of cases with childhood or juvenile cases of HD.² In these patients it might present with the symptoms of progressive myoclonus epilepsy (PME).^3-5 We describe siblings with differing HD manifestations: The index patient (P) presented with PME and the akinetic-rigid variant and had disease onset of 17 years. One sister (S2) with the same age of onset also presented with choreatic symptoms at the age of 24 years.

The (CAG) trinucleotide repeat analysis showed the largest expansion in