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Paroxysmal Kinesigenic Dyskinesia

PKC


Presentation

  • Paroxysmal kinesigenic dyskinesia (PKD) is presented as a short paroxysmal attack of focal or generalized involuntary movement.[ncbi.nlm.nih.gov]
  • A 42-year-old woman and her 13-year-old daughter both presented with episodic curling of their hand and arm. These events were triggered by sudden movements and would last several seconds.[ncbi.nlm.nih.gov]
  • As in the present case, a PKD-like phenotype may be associated with MS relapses in presumably genetic negative cases.[ncbi.nlm.nih.gov]
  • CASE PRESENTATION: A previously not recognized intronic PRRT2 mutation (c.880-35G A; p.S294Lfs*29) was found in an 18 month old girl with IC and in her mother with classical presentation of PKD.[ncbi.nlm.nih.gov]
  • RESULTS: Mean age at disease onset was 8 years 7.5 months (range 5-11y), and clinical presentation was characterized by daily short paroxysmal episodes of dystonia/dyskinesia.[ncbi.nlm.nih.gov]
Asymptomatic
  • The patient became asymptomatic within 3 months. PKD is characterized by recurrent uni- or bilateral choreoathetosis and usually represents an autosomal dominant inherited disorder caused by PRRT2 gene mutations.[ncbi.nlm.nih.gov]
  • His father, when young, had similar limb stiffness, while his mother and brother were asymptomatic. Genetic analysis revealed that the proband and his father harbored a PRRT2 c.649dupC mutation, and CLCN1 c.1723C T and c.2492A G mutations.[ncbi.nlm.nih.gov]
  • The other three siblings of the proband were asymptomatic. Mutational analysis for PRRT2 gene Exons of PRRT2 were amplified using polymerase chain reaction, of which its conditions and primer sequences for PRRT2 are available upon request.[hkmj.org]
  • Affected individuals are represented by filled/black symbols and asymptomatic family members by empty/white symbols. Symbols of deceased individuals are slashed. Probands are denoted with arrows.[bmcneurol.biomedcentral.com]
Vietnamese
  • METHODS: Sanger sequencing was used to analyze all four PRRT2 exons for sequence variants in 13 probands (9 Caucasian, 1 Caucasian-Thai, 1 Vietnamese and 2 African-American) with some form of paroxysmal dyskinesia.[ncbi.nlm.nih.gov]
  • Methods Sanger sequencing was used to analyze all four PRRT2 exons for sequence variants in 13 probands (9 Caucasian, 1 Caucasian-Thai, 1 Vietnamese and 2 African-American) with some form of paroxysmal dyskinesia.[bmcneurol.biomedcentral.com]
Weight Gain
  • Earlier this year I was finally put on medication that works with only a slight constant weight gain (which kinda sucks, to be quite honest, as some medication I was on as a kid completely stopped my metabolism and it never really returned to its fully[neurotalk.org]
Paranoid Ideation
  • ideation, and psychoticism; P 0.000 for all) and significantly lower (worse) scores of five domains in WHOQoL-100 (physical domain, psychological domain, independence domain, social relationship domain, and general quality of life; P 0.000 for all).[ncbi.nlm.nih.gov]
  • ideation, psychoticism; P 0.000, for all).[cjcnn.org]
Abnormal Involuntary Movement
  • We report on seven children who developed abnormal involuntary movements as early as 1.5 years after unremarkable term births. The paroxysmal episodes of abnormal movements were typically precipitated by sudden, voluntary movements, or a startle.[ncbi.nlm.nih.gov]
  • Paroxysmal kinesigenic dyskinesia (PKD) is a rare disorder characterised by brief and frequent attacks of abnormal involuntary movements induced by sudden movement. This disorder has not been reported previously in Sri Lanka.[ncbi.nlm.nih.gov]
  • involuntary movement that is episodic or intermittent, with sudden onset, and the attacks are induced by sudden movement.[annalsofian.org]
  • PxD is a class of heterogeneous motor disorders characterized by abnormal involuntary movement with no alteration to consciousness. It is usually under-diagnosed if not delayed-diagnosed, as the patients are normal between episodes.[ruralneuropractice.com]
  • Indeed, deletions at 16p12-p11 have recently been detected in four patients with sporadic microdeletion syndrome consisting of developmental disabilities, 83 but none of the four patients had ever shown epileptic seizures or abnormal involuntary movements[doi.org]

Workup

  • Workup for his symptoms including blood counts, electrolytes, calcium, thyroid functions, vasculitic workup, magnetic resonance imaging (MRI) brain, and electroencephalogram (EEG) were all within normal limits.[annalsofian.org]
  • We describe the case of a young female patient who was admitted for diagnostic workup: epileptic seizures versus psychogenic movement disorders.[e-jmd.org]
Epileptiform Activity
  • The electroencephalogram (EEG) showed neither asymmetric nor epileptiform activities.[e-jmd.org]

Treatment

  • The apparent benign nature of the disorder, as well as treatment options with antiepileptic drugs, was discussed with the parents, and most chose no pharmacologic treatment.[ncbi.nlm.nih.gov]
  • Treatment with carbamazepine improved their symptoms. Although an uncommon movement disorder it is important to recognize the clinical presentation of paroxysmal kinesigenic dyskinesia as most patients respond very well to medical treatment.[ncbi.nlm.nih.gov]
  • Treatment with carbamazepine normalized the abnormalities in transcallosal inhibition, but had no effect on other parameters.[ncbi.nlm.nih.gov]
  • METHODS: We recruited a cohort of PKD patients with or without PRRT2 mutations for the study, and followed them for 6 months to observe the response to carbamazepine treatment.[ncbi.nlm.nih.gov]
  • We compared the efficacy and tolerability of oxcarbazepine (OXC) and carbamazepine (CBZ) in the treatment of PKD, in order to find the optimal prescription.[ncbi.nlm.nih.gov]

Prognosis

  • The correct diagnosis has implications for treatment and prognosis, and the diagnostic scheme may allow better focus in the search for the PKD gene(s).[ncbi.nlm.nih.gov]
  • The correct diagnosis has implications for treatment and prognosis, and the diagnostic scheme may allow better focus in the search for the PKD gene(s). Received April 1, 2004. Accepted September 1, 2004.[neurology.org]
  • Prognosis ICCA has a good outcome. Without treatment, dyskinetic attacks tend to disappear during adulthood. The documents contained in this web site are presented for information purposes only.[orpha.net]
  • Typically, patients receive antiepileptic medications, and improvement of symptoms is usually associated with a good prognosis. If symptoms do not improve with antiepileptic medication(s), the prognosis is not favorable.[encyclopedia.com]
  • I can't predict your prognosis. Even the doctor's don't know that. I know all this is frustrating. bes of luck.[dailystrength.org]

Etiology

  • PURPOSE: Paroxysmal kinesigenic dyskinesia (PKD) and epilepsy are thought to have a shared genetic etiology. PRRT2 has been identified as a causative gene of both disorders.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: PRRT2 mutations are the major cause of PKD or ICCA, but they do not seem to be involved in the etiology of febrile convulsions and migraine.[ncbi.nlm.nih.gov]
  • In 1995, Dermirkiran and Jankovic [10] associated a wide range of etiologies to PNKD, for example, autoimmune, vascular, traumatic, infective, and endocrine disorder.[ruralneuropractice.com]
  • Genetic analysis implicates APOE, SNCA and suggests lysosomal dysfunction in the etiology of dementia with Lewy bodies. Hum Mol Genet. PubMed PMID: 24973356 Guerreiro R, Wojtas A, Bras J, et al. TREM2 variants in Alzheimer's disease. N Engl J Med.[books.google.com]
  • Etiology The genetic loci of ICCA syndrome have been described on chromosomes 16p11.2-q12.1, 16q13-q22.1 and 3q29-29.[orpha.net]

Epidemiology

  • Summary Epidemiology This disorder is rare but the exact prevalence is unknown. Clinical description Benign familial infantile epilepsy begins at 3 to 12 months of age with a family history of the same type of seizures.[orpha.net]
  • Jianfeng Xu Fudan–Van Andel Research Institute (VARI) Center for Genetic Epidemiology, School of Life Science, Fudan University, Shanghai, China.[nature.com]
  • Common clinical features, epidemiological studies, shared therapeutic strategies, and familial co-inheritance all argue in favour of close relationships between various epileptic syndromes and other paroxysmal disorders of the brain, 35 such as migraine[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Little is known of the pathophysiology of PKD, although an ion channel abnormality is thought likely. We assessed a number of electrophysiological parameters in 11 patients with idiopathic PKD, a proportion of them on and off treatment.[ncbi.nlm.nih.gov]
  • Understanding the pathophysiology of PKD may facilitate discrimination between PKD-D and PKD-C, potentially contributing to more accurate diagnosis.[ncbi.nlm.nih.gov]
  • The results of this study suggest that the pathophysiology of PKD cannot be simply explained by lesions of the basal ganglia or thalamus, and that other associated areas of the cortex are likely involved in these movement disorders.[ncbi.nlm.nih.gov]
  • We discuss clinical characteristics of PKD, treatment with anticonvulsant therapy, and recent insights into its possible pathophysiology.[ncbi.nlm.nih.gov]
  • Here, we discuss the clinical characteristics, especially the abnormalities of investigations and misdiagnosis, and recent insights into the pathophysiology of PKD. Copyright 2012 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]

Prevention

  • CONCLUSIONS: This finding may represent that the operation of SI is extended to the post-movement period, perhaps as a compensatory mechanism for preventing unwanted movement in surrounding muscles.[ncbi.nlm.nih.gov]
  • Mutagenesis Feature key Position(s) Description Actions Graphical view Length Mutagenesis i 214 I A: Prevents binding with num-1 (isoform a and isoform c). 1 Mutagenesis i 216 N A: Prevents binding with num-1 (isoform a and isoform c). 1 Mutagenesis i[uniprot.org]
  • In this state, the pseudosubstrate sequence of the regulatory domain of PKC interacts with the Catalytic domain and prevents access of the substrate to the catalytic site.[qiagen.com]
  • […] citrate, in doses of 50-200 mg/kg, was shown to significantly reduce parkinsonian dyskinesia in Parkinson’s-induced monkeys. 9 Another study, published in 2005 in the Journal of Anesthesia and Analgesia, looked at the ability of magnesium sulfate to prevent[ndnr.com]
  • European Russia, the Volga Region, the Russia Caucasus, Sochi, Lake Baikal, the Urals, Yekaterinburg, Siberia, Irkutsk, Vladivostok, Kamchatka and more eBook Features: (Best viewed on tablet devices and smartphones) Downloadable PDF and offline maps prevent[books.google.es]

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