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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
PubMed

Insights

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.

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