Journal Article

Psychogenic seizures in a child with infantile convulsions and choreoathetosis

Kurotaki, Naohiro, Nagata, Satoru, Ito, Susumu, Saito, Kayoko, Shimomura, Rina

2022

Overview

[...]the patient also frequently experienced other episodes of paroxysmal walking impairment, which were at first considered as paroxysmal dyskinesias because of the recurrent and sudden symptoms. The long-term video electroencephalogram (EEG) captured the frequent episodes of paroxysmal sudden behavior arrest, but the corresponding EEGs did not show any changes in ongoing activity or epileptiform abnormalities. [...]a video of the paroxysmal episodes of unsteady staggered-like gait without falling did not reveal any dystonic / choreoathetotic movements, which was also inconsistent with PKC as well as other paroxysmal dyskinesias (Table 1). [...]PNES and PPMD were strongly suspected for the episodes. Table 1 Comparison of paroxysmal dyskinesias and our case PKC PED PNKD Our case OMIM # #128200 #612126 #118800 Onset age Childhood - early adulthood Childhood Infancy - childhood Seven years old Symptoms Dystonia, chorea, athetosis Dystonia, choreoathetosis Dystonia, chorea, athetosis Unsteady staggered-like gait Frequency Daily Weekly Weekly Throughout the day Duration Seconds to minutes Minutes to hours Minutes to hours Minutes to hours Triggers Sudden voluntary movement Exercise, exertion Stress, fatigue, caffeine, alcohol, ovulation, menstruation None (from the beginning of walking) Gene PRRT2 SLC2A1 MR1 PRRT2 Treatment Carbamazepine, phenytoin Ketogenic diet Benzodiazepines Psychosocial intervention PED, paroxysmal exercise-induced dyskinesia; PKC, paroxysmal kinesigenic choreoathetosis; PNKD, paroxysmal non-kinesigenic dyskinesia.

• Publisher: John Wiley & Sons, Inc
• Subject: Age / Convulsions & seizures / Dyskinesia / Dystonia / Electroencephalography / Epilepsy / Walking