title: Paroxysmal Kinesigenic Dyskinesia-like Symptoms in a Patient with Tourette Syndrome.
abstract: BACKGROUND
  Paroxysmal kinesigenic dyskinesia (PKD) is characterized by episodic dystonia or choreiform movements provoked by sudden voluntary movement. PKD is not commonly reported in Tourette syndrome (TS). We describe a unique case of TS with PKD-like episodic dyskinesia that responded to carbamazepine.
  
  
  METHODS
  A 36-year-old male with long-standing TS developed paroxysmal "cramping". Attacks were provoked by quick, sudden arm movements, which induced dystonic cramping, or by reaching overhead, which caused painful contraction of truncal muscles. The spells typically lasted 5-20 seconds and occurred multiple times daily. The patient's mother suffered from intermittent dystonic toe curling. In view of the similarity of symptoms to PKD, carbamazepine was prescribed at 400 mg daily. The symptoms resolved completely. Inadvertent discontinuation led to relapse, and resumption led to recapture of benefit.
  
  
  CONCLUSIONS
  This case demonstrates the possibility that PKD-like symptoms may co-occur with TS and may be responsive to carbamazepine.
authors: Department of Neurology, University of Florida College of Medicine/Shands Hospital, Movement Disorders Center, Florida, United States of America ; Mcknight Brain Institute, Galnesville, Florida, United States of America.
authors: Genko
authors: G
authors: Oyama
authors: Michael S
authors: MS
authors: Okun
authors: Tetsuo
authors: T
authors: Ashizawa
authors: Irene A
authors: IA
authors: Malaty
keywords: Tourette syndrome; paroxysmal kinesigenic dyskinesia