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We studied 46 patients with paroxysmal dyskinesia and classified them according to phenomenology,duration of attacks,and etiology.There were 13 patients,7 females,who had paroxysmal kinesigenic dyskinesia(PKD),10 with attacks lasting 5 minutes or less(short lasting)and 3 with attacks lasting longer than 5 minutes(long lasting).Twenty-six patients,18 females,had paroxysmal nonkinesigenic dyskinesia(PNKD),9 with short-lasting and 17 with long-lasting PNKD.Five patients,3 females,had paroxysmal exertion- induced dyskinesia(PED),3 with short-lasting PED and the other 2 with long-lasting PED.In addition,there was 1 patient with paroxysmal hypnogenic dyskinesia(PHD)and 1 with paroxysmal superior oblique myokymia. Only 2 patients,1 with PKD and 1 with PHD,had family history of paroxysmal dyskinesias.No specific cause could be identified in 21 patients;in the other 23 patients the etiologies included the following:psychogenic(9 patients),cerebrovascular diseases(4),multiple sclerosis(2),encephalitis (2),cerebral trauma(2),peripheral trauma(2),migraine(1),and kernicterus (1).Nine of 10(90%)patients with PKD improved with medications,mostly anticonvulsants,compared with only 7 of 19(37%)with PNKd.This new classification,based chiefly on precipitating events,allowed appropriate categorization of the attacks in all our patients with paroxysmal dyskinesias. |
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