Extreia J, Monteiro I, Ferreira A, Rocha S
Servicio de Pediatría, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.
Servicio de Pediatría, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.
An Pediatr (Barc). 2015 Jan;82(1):e154-7. doi: 10.1016/j.anpedi.2014.07.020. Epub 2014 Sep 7.
Paroxysmal dyskinesias are movement disorders characterized by sudden episodes of involuntary movements. They are divided into kinesigenic, non-kinesigenic, and exercise-induced dyskinesias. Emphasis is made on the importance of the clinical history and fully describing the episodes in the differential diagnosis. The case is presented of a twelve year-old female with paroxysmal episodes of tongue torsion and dystonic postures of the upper limbs when start running or descending stairs and in the beginning of physical exercise, which ceased spontaneously seconds later. Some episodes were triggered by stress. In family history her father, paternal uncle, and sister also had paroxysmal movements. Interictal neurological examination was normal. Laboratory tests revealed a mutation in PRRT2 gene, which is related to neurological disorders such as paroxysmal kinesigenic dyskinesia, infantile convulsions and choreoathetosis migraine, episodic ataxia, paroxysmal torticollis, and intellectual disability. Treatment with carbamazepine was effective.
发作性运动障碍是一类以突发的不自主运动发作为特征的运动障碍性疾病。它们分为发作性运动诱发性运动障碍、非运动诱发性运动障碍和运动诱发的运动障碍。在鉴别诊断中,强调临床病史的重要性以及对发作情况进行全面描述。本文报道了一例12岁女性患者,在开始跑步、下楼梯及体育锻炼开始时出现阵发性舌扭转及上肢肌张力障碍姿势,数秒后自行停止。部分发作由压力诱发。家族史显示其父亲、伯父及姐姐也有阵发性运动。发作间期神经系统检查正常。实验室检查发现PRRT2基因存在突变,该基因与发作性运动诱发性运动障碍、婴儿惊厥和舞蹈手足徐动症偏头痛、发作性共济失调、阵发性斜颈及智力障碍等神经系统疾病相关。卡马西平治疗有效。