Idiopathic paroxysmal kinesigenic choreoathetosis: precipitation of attacks by vestibular stimulation.
A 24-year-old woman presented with a 3.5-year history of paroxysmal dystonia that was precipitated by sudden movement, especially when she started to walk. It was characterised by shrugging of shoulders, flexion of the neck and thoracic spine, and stiffness of the right leg followed by falls. Each attack lasted for less than 5min. Inadequate sleep and stress were exacerbating factors. There was no similar family history. Physical examination and investigations were normal. The following manoeuvres that caused vestibular stimulation precipitated attacks: turning her head from side to side while standing still, sitting still on a rotating chair and an ice-water caloric test. She had partial responses to phenytoin and levodopa, and a good response to haloperidol. Vestibular stimulation as a precipitating factor in paroxysmal kinesigenic choreoathetosis has not been reported previously.
Chew
Nee-Kong
NK
Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia. nkchew33@hotmail.com
Tan
Chong-Tin
CT
Goh
Khean-Jin
KJ
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001264:Athetosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D002819:Chorea / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D010812:Physical Stimulation; D012008:Recurrence; D014722:Vestibule, Labyrinth / Q000502:physiology*
D000927:Anticonvulsants