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Paroxysmal movement disorders.

Francesca Magrinelli1, Kailash P Bhatia1

  • 1Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.

Handbook of Clinical Neurology
|August 22, 2024
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Summary
This summary is machine-generated.

Paroxysmal dyskinesias are intermittent movement disorders characterized by involuntary movements. Research highlights their genetic, pathophysiologic, and treatment aspects, revealing shared pathways with epilepsy and migraine.

Keywords:
ChannelopathyChoreaDystoniaExercise-inducedKinesigenicNonkinesigenicParoxysmal dyskinesiaSynaptopathyTransportopathyTrigger

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Area of Science:

  • Neurology
  • Neurogenetics

Background:

  • Paroxysmal movement disorders encompass paroxysmal dyskinesia (intermittent hyperkinetic movements with preserved consciousness) and episodic ataxias (attacks of cerebellar dysfunction).
  • This review focuses on paroxysmal dyskinesia, detailing its subtypes: paroxysmal kinesigenic, nonkinesigenic, and exercise-induced dyskinesia.

Purpose of the Study:

  • To provide a comprehensive overview of paroxysmal dyskinesia, including its phenotypic, genetic, pathophysiologic, diagnostic, and treatment characteristics.
  • To explore emerging subtypes of paroxysmal dyskinesia.
  • To discuss the phenotypic and genotypic overlap between paroxysmal movement disorders, epilepsy, and migraine.

Main Methods:

  • Review of existing literature on paroxysmal dyskinesia.
  • Analysis of phenotypic and genotypic data.
  • Exploration of pathophysiologic mechanisms.

Main Results:

  • Paroxysmal dyskinesia is classified into kinesigenic, nonkinesigenic, and exercise-induced subtypes, with emerging categories also identified.
  • Significant overlap exists between paroxysmal movement disorders, epilepsy, and migraine, suggesting shared underlying pathophysiologic frameworks.
  • Pathomechanisms involve ion channel dysfunction, synaptic vesicle machinery issues, and neuronal energy metabolism deficits, pointing to converging pathways.

Conclusions:

  • Understanding the converging pathophysiologic pathways of paroxysmal dyskinesia is crucial for developing targeted therapies.
  • The identified overlaps provide insights into the broader spectrum of neurological disorders and potential therapeutic strategies.