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Kinesigenic attacks with ictal electroencephalographic abnormalities
Tomoyuki Akiyama1, Yoko Ohtsuka, Katsuhiro Kobayashi
1Department of Child Neurology, Okayama University Medical School, Okayama, Japan.
Pediatric Neurology
|November 3, 2004
Summary
This study presents a case of paroxysmal kinesigenic choreoathetosis triggered by sudden movements. Carbamazepine effectively treated the attacks, highlighting the importance of electroencephalography in diagnosis.
Area of Science:
- Neurology
- Epileptology
Background:
- Paroxysmal kinesigenic choreoathetosis (PKC) is a rare movement disorder characterized by sudden, involuntary choreoathetoid movements.
- Attacks are typically triggered by voluntary movements and can be associated with other neurological symptoms.
Observation:
- A 14-year-old male presented with attacks resembling PKC, exclusively triggered by sudden movements.
- Some episodes were followed by loss of consciousness or seizures.
- Ictal electroencephalograms (EEGs) during non-seizure attacks showed 1.5-3.0 Hz activity in the left hemisphere.
Findings:
- A low dose of carbamazepine proved highly effective in suppressing the patient's attacks.
- The findings suggest a link between paroxysmal kinesigenic choreoathetosis and supplementary motor area seizures.
- Ictal EEG is crucial for understanding the pathophysiology of kinesigenic attacks.
Implications:
- This case underscores the diagnostic value of ictal EEG in differentiating movement disorders and seizures.
- It suggests that supplementary motor area seizures may manifest as or be associated with paroxysmal kinesigenic choreoathetosis.
- Pharmacological management with carbamazepine can be effective for such presentations.