Epilepsy as the presenting feature of neuroacanthocytosis in siblings

A brother and sister developed epilepsy at the age of 28 and 30 years respectively, and were subsequently found to have neuroacanthocytosis. The brother developed tics, and a tendency to self-mutilate a year later, but his sister had not developed any movement disorder in the 5 years since the onset of epilepsy. In families with epilepsy, the diagnosis of neuroacanthocytosis should be considered, particularly when one family member has tics or other involuntary movements.