Paroxysmal exercise-induced dyskinesia without involuntary movements

Area of Science:

• Neurology
• Movement Disorders

Background:

• Paroxysmal exercise-induced dyskinesia is a rare condition characterized by involuntary movements triggered by exercise.
• Gait disturbance can be a presenting symptom, even without observable involuntary movements.

Observation:

• A 66-year-old man presented with a 2.5-year history of bilateral lower limb weakness upon walking.
• Symptoms necessitated rest periods of up to 15 minutes after approximately 10 minutes of ambulation.

Findings:

• Treatment with carbamazepine at 200 mg/day reduced symptom severity and frequency by half.
• Complete resolution of symptoms was achieved with a carbamazepine dose of 300 mg/day.

Implications:

• Paroxysmal painless gait disturbance warrants consideration of paroxysmal exercise-induced dyskinesia.
• A therapeutic trial of anticonvulsants, such as carbamazepine, may be beneficial for managing this condition.