Clinical Features and Treatment in the Spectrum of Paroxysmal Dyskinesias: An Observational Study in South-West Castilla y Leon, Spain
Table 2
Summary of the results of cases sample identified as secondary paroxysmal dyskinesias.
Case number/ Cause
Sex
Age at onset (years)
PxD
Predominant movement
Duration
Frequency
Aura
Location
Precipitants or exacerbating factors
Treatment
Evolution
S1/ MS
F
32
PNKD
D
2-5 min
3/day
Yes
U: Right hand
Rest
OXC
Remission in 1 month
S2/ CVD
F
60
PKD/PNKD
D
2-3 min
4/week -> 2-3/day
No
G or U: Left hand or foot
Rest, sudden movement
L-dopa
Improvement with L-dopa
S3/ HIV, encephalitis
M
29
PNKD
CD
<5 min
10-20/day
No
U: Left arm and leg, face, trunk
Rest
CZP, DPH, VPA, CBZ, LEV iv
No improvement. Death after 2 months by pneumonia
S4/ fluoxe-tine
F
34
PNKD
D
3-5 min
1-5/day
Yes
U: Left arm and leg
Rest, stress
Remove SSRIs, BZD
Remission after withdrawal
S5/ escita-lopram
M
27
PNKD
D
15 min
3/day
No
U: Left hand
Hand rest, walking
Remove SSRIs, GBP
Remission alter withdrawal
S6/ fungal encephalitis
M
81
PNKD
CD
30-60 min
5-10/ day
No
U: Right arm and leg
Rest
CZP, DPH, LEV iv
No improvement. Death after 1 day
S7/ hipoPTH
F
68
PKD
D
< 1 min
1/week
No
A: Hands or feet
Sudden movement
Calcium
Improvement with calcium
S8/ haemorrhage
F
77
PNKD
C
<5 min
10-20/day
No
U: Left arm and leg
Rest
CZP iv
Remission in 1 week
S9/ peripheral trauma
F
51
PED
CD
15-30 min
2-4/day
No
U: Right foot
Exercise
TBZ, CZP, trihexyphenidyl
Improvement with trihexyphenidyl
At the time with the larger number of episodes; S: secondary; MS: multiple sclerosis; CVD: cerebrovascular disease; PTH: parathyroidism; M: male; F: female; D: dystonia; CD: mixed chorea and dystonia; A: alternant (sometimes affects one side and others to the another one); U: unilateral; G: generalized; OXC: oxcarbazepine; CZP: clonazepam; DPH: difenilhidantoina; VPA: valproic acid; CBZ: carbamazepine; LEV: levetiracetam; IV: intravenous; SSRIs: selective serotonin reuptake inhibitors; BZD: benzodiazepines; GBP: gabapentin; TBZ: tetrabenazine. Besides the etiological treatment: antiretroviral agents (lopinavir/ritonavir; emtricitabine/tenofovir), antitoxoplasma therapy and steroids in S3, and antifungals in S6.
