title: Paroxysmal non-kinesigenic dyskinesia, post-streptococcal syndromes and psychogenic movement disorders: a diagnostic challenge.
abstract: We report a case of a 15-year-old boy presenting with sudden attacks of hyperkinetic movements of the limbs, trunk and neck. Clinical features were suggestive of paroxysmal non-kinesigenic dyskinesia, but the elevated antistreptolysin O antibody titre and history of recurrent upper airways infection led us to consider a post-streptococcal syndrome as a possible diagnosis. The patient started therapy with benzathine penicillin, sodium valproate and clonazepam without any significant improvement. A successive psychiatric assessment revealed the presence of a psychogenic movement disorder. Psychodynamic psychotherapy and individual counselling were started with progressive improvement of psychological symptoms and gradual resolution of hyperkinetic episodes, without any recurrence recorded during the follow-up (10 months).
authors: Department of Neuroscience, University of Turin, Turin, Italy.
authors: Elena
authors: E
authors: Peila
authors: Department of Neuroscience, University of Turin, Turin, Italy.
authors: Paolo
authors: P
authors: Mortara
authors: Department of Neuroscience, University of Turin, Turin, Italy.
authors: Alessandro
authors: A
authors: Cicerale
authors: Department of Neuroscience, University of Turin, Turin, Italy.
authors: Lorenzo
authors: L
authors: Pinessi
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D003937:Diagnosis, Differential; D037001:Directive Counseling; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009069:Movement Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D064889:Psychotherapy, Psychodynamic / Q000379:methods; D016896:Treatment Outcome