title: Secondary paroxysmal dyskinesia in multiple sclerosis: Clinical-radiological features and treatment. Case report of seven patients.
abstract: Secondary paroxysmal dyskinesias (SPDs) are short, episodic, and recurrent movement disorders, classically related to multiple sclerosis (MS). Carbamazepine is effective, but with risk of adverse reactions. We identified 7 patients with SPD among 457 MS patients (1.53%). SPD occurred in face ( n = 1), leg ( n = 2), or arm +leg ( n = 4) several times during the day. Magnetic resonance imaging (MRI) showed new or enhancing lesions in thalamus ( n = 1), mesencephalic tegmentum ( n = 1), and cerebellar peduncles ( n = 5). Patients were treated with clonazepam and then acetazolamide ( n = 1), acetazolamide ( n = 5), or levetiracetam ( n = 1) with response within hours (acetazolamide) to days (levetiracetam). No recurrences or adverse events were reported after a median follow-up of 33 months.
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Hospital Sótero del Río, Santiago, Chile.
authors.forename: Ethel
authors.initials: E
authors.lastname: Ciampi
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Hospital Sótero del Río, Santiago, Chile.
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Uribe-San-Martín
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Jaime
authors.initials: J
authors.lastname: Godoy-Santín
authors.affiliation: Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Cruz
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cárcamo-Rodríguez
authors.affiliation: Department of Neurology, Pontificia Universidad Católica de Chile, Hospital Sótero del Río, Santiago, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Juri
mesh_terms: D000086:Acetazolamide / Q000494:pharmacology; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000494:pharmacology*; D002531:Cerebellum / Q000000981:diagnostic imaging*; D002998:Clonazepam / Q000494:pharmacology; D020820:Dyskinesias / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004421:Dystonia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D010889:Piracetam / Q000031:analogs & derivatives / Q000494:pharmacology; D013681:Tegmentum Mesencephali / Q000000981:diagnostic imaging*; D013788:Thalamus / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D002998:Clonazepam; D000086:Acetazolamide; D010889:Piracetam
keywords: MRI; Multiple sclerosis; dystonia; movement disorders; paroxysmal dyskinesia