[A child with paroxysmal exertion-induced dyskinesia].
We experienced a 12-year-old boy with paroxysmal exertion (exercise)-induced dyskinesia (PED). His attacks, characterized by painless paralytic stiffness of the extremities during running or playing, developed at 4 years of age. He was initially diagnosed as having epilepsy based on epileptic discharges on interictal EEG. Although several anti-epileptic drugs were not effective, clorazepate was found to be very useful for complete control of attacks for 3 years. His attacks recurred at 8 years of age and appeared to be aggravated by psychological stress, fatigue and lack of sleep. His attacks were confirmed to be non-epileptic paroxysmal hypokinesia with rigid tetraplegia, by ictal video EEG recording, and he was diagnosed as having PED. They did not respond to various anti-epileptic drugs and L-dopa/carbidopa. His attacks were reduced to some extent by administration of hydroxyzine. PED is a very rare condition and similar to paroxysmal kinesigenic dyskinesia (PKD). There is a strong possibility that patients with PED have been misdiagnosed as PKD.
Department of Pediatrics, School of Medicine, Tokyo Women's Medical University, Tokyo.
Takatoshi
T
Sato
Yasushi
Y
Ito
Hirokazu
H
Oguni
Kaoru
K
Eto
Akiko
A
Fujii
Makiko
M
Osawa
D002648:Child; D002819:Chorea / Q000209:etiology*; D006801:Humans; D008297:Male; D005082:Physical Exertion