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Case Reports in Neurological Medicine
Volume 2012, Article ID 484689, 3 pages
Case Report

Paroxysmal Hypnogenic Dyskinesia Responsive to Doxylamine: A Case Report

Department of Psychiatry, Scott & White Healthcare, 2401 South 31st Street, Temple, TX 76508, USA

Received 30 April 2012; Accepted 21 June 2012

Academic Editors: R. Koide, M. Kurz, and K. Wessel

Copyright © 2012 Daniel M. Williams. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Paroxysmal hypnogenic dyskinesia is a rare clinical entity characterized by intermittent dystonia and choreoathetoid movements that begin exclusively during sleep, often with consciousness preserved once the patient is awakened during the episodes. They occur almost every night and are often misdiagnosed as sleeping disorders. Paroxysmal hypnogenic dyskinesia is currently known to be a form of frontal lobe epilepsy, but not in all cases. We present a 19-year-old male patient with paroxysmal hypnogenic dyskinesia who responded to antihistamines. This supports an alternative theory from 1977 (before the cases had been adequately described) that the disorder lies in dysregulation in the basal ganglia. This description now appears similar to acute dystonic reactions such as extrapyramidal symptoms from antipsychotic medications, which also respond to antihistamines.