Paroxysmal dyskinesias: clinical features and classification

M Demirkiran, J Jankovic - … of Neurology: Official Journal of the …, 1995 - Wiley Online Library
M Demirkiran, J Jankovic
Annals of Neurology: Official Journal of the American Neurological …, 1995Wiley Online Library
We studied 46 patients with paroxysmal dyskinesia and classified them according to
phenomenology, duration of attacks, and etiology. There were 13 patients, 7 females, who
had paroxysmal kinesigenic dyskinesia (PKD), 10 with attacks lasting 5 minutes or less
(short lasting) and 3 with attacks lasting longer than 5 minutes (long lasting). Twentysix
patients, 18 females, had paroxysmal nonkinesigenic dyskinesia (PNKD), 9 with short‐
lasting and 17 with longlasting PNKD. Five patients, 3 females, had paroxysmal exertion …
Abstract
We studied 46 patients with paroxysmal dyskinesia and classified them according to phenomenology, duration of attacks, and etiology. There were 13 patients, 7 females, who had paroxysmal kinesigenic dyskinesia (PKD), 10 with attacks lasting 5 minutes or less (short lasting) and 3 with attacks lasting longer than 5 minutes (long lasting). Twentysix patients, 18 females, had paroxysmal nonkinesigenic dyskinesia (PNKD), 9 with short‐lasting and 17 with longlasting PNKD. Five patients, 3 females, had paroxysmal exertion‐induced dyskinesia (PED), 3 with short‐lasting PED and the other 2 with long‐lasting PED. In addition, there was 1 patient with paroxysmal hypnogenic dyskinesia (PhD) and 1 with paroxysmal superior oblique myokymia. Only 2 patients, 1 with PKD and 1 with PhD, had family history of paroxysmal dyskinesias. No specific cause could be identified in 21 patients; in the other 23 patients the etiologies included the following: psychogenic (9 patients), cerebrovascular diseases (4), multiple sclerosis (2), encephalitis (2), cerebral trauma (2), peripheral trauma (2), migraine (1), and kernicterus (1). Nine of 10 (90%) patients with PKD improved with medications, mostly anticonvulsants, compared with only 7 of 19 (37%) with PNKD. This new classification, based chiefly on precipitating events, allowed appropriate categorization of the attacks in all our patients with paroxysmal dyskinesias.
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