Paroxysmal Dyskinesia: Report of Four Cases

Abstract

Paroxysmal dyskinesias are heterogenous group of disorders characterised by suddenabnormal involuntary movements. We like to present 3 cases of idiopathic and 1 case of secondary paroxysmal dyskinesia to emphasize the disorder and dramatic response to low dose anti-epileptics. In patients 1 and 4 movements limited to one side of the body and precipitated by motion were considered as "paroxysmal kinesigenic dyskinesiawith short-lasting attacks". The etiology of paroxysmal kinesigenic dyskinesia was multiple sclerosis in patient 3. Magnetic resonance imaging (MRI) revealedhyperintense, demyelinating plaques in cervical and upper thoracal spinal cord. Finally, in patient 2 dystonic movements of the hand and feet was present during sleep. The disorder was accepted as "paroxysmal hypnogenic dyskinesia" as the patient was conscious during the attack, clinical discordance to epileptic seizure types and normalelectroencephalogram. All the patients well responded to low dose carbamazepine treatment.