Snapshot A 53-year-old man presents with involuntary jerking movement of the arms. This is worsened with voluntary movement and appears to be nonrepetitive. He tries to incorporate these movements into voluntary movement. He states that this is negatively affecting his quality of life, as he has difficulty with activities of daily living. Family history is significant for Huntington's disease in the father. On physical examination, there is impaired fine motor movements and choreiform movement of the upper extremity. He is started on tetrabenazine. Introduction Huntington's disease (HD) autosomal dominant neurodegenerative disorder secondary to CAG repeat on chromosome 4 characterized by chorea, psychiatric disturbance, and cognitive decline no known cure; therefore, treatment is symptomatic changes in neurotransmitters with HD ↑ dopamine, ↓ GABA, and ↓ACh login to view 3 more bullets Medications treatment for chorea tetrabenazine login to view 2 more bullets treatment for psychiatric and behavioral symptoms psychosis/agitation login to view 3 more bullets depression login to view 3 more bullets