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James M, Garosi L, Bessant C, Lowrie M. Phenotypic characterisation of paroxysmal dyskinesia in Sphynx cats. J Feline Med Surg 2022; 24:500-505. [PMID: 34313487 PMCID: PMC11104236 DOI: 10.1177/1098612x211032123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to identify the phenotypic features of a paroxysmal dyskinesia observed in Sphynx cats. METHODS The owners of affected Sphynx cats were invited to provide video footage of abnormal episodes for review. Those that demonstrated episodes consistent with paroxysmal dyskinesia were then invited to complete an online questionnaire designed to allow further characterisation. RESULTS Ten Sphynx cats were included in the study. All affected cats were <4 years of age at the onset of the episodes (range 0.5-4.0). The episodes had a duration of <5 mins in 9/10 cats (range 0.5-10), while episode frequency was variable between and within individual cats. The episodes were characterised by impaired ambulation due to muscle hypertonicity, most commonly affecting the hips and pelvic limbs (9/10) and shoulders and thoracic limbs (8/10). The head and neck (6/10), tail (5/10), and back and abdomen (3/10) were also involved in some cats. Sudden movement, excitement and stress were identified as possible triggers for the episodes in three cats. Therapeutic intervention was not attempted in 7/10 cases, although two cats were reported to become free of the episodes while receiving acetazolamide. The two cats that were followed beyond 2 years from onset entered spontaneous remission. None of the owners believed that the abnormal episodes had affected the quality of life of their cat. CONCLUSIONS AND RELEVANCE The phenotype of paroxysmal dyskinesia in Sphynx cats presented in this study appears to share similarities with paroxysmal kinesigenic dyskinesia described in human classification systems. Some cats appear to achieve episode freedom spontaneously. Subsequent research should focus on evaluating response to treatment and determining an underlying genetic cause.
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2
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Brocal J, Lowrie M, Wamsley G, Cauduro A, Mandigers P, Gutierrez-Quintana R, Stalin C. Epileptic seizures triggered by eating in dogs. J Vet Intern Med 2020; 34:1231-1238. [PMID: 32343869 PMCID: PMC7255664 DOI: 10.1111/jvim.15773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/17/2020] [Indexed: 01/30/2023] Open
Abstract
Background Seizures triggered by eating (STE) behavior are very rare in humans and have not been documented previously in dogs. Objectives To document the occurrence of STE in dogs and describe their clinical features. Animals Ten client‐owned dogs with STE diagnosed at 5 European referral centers. Methods A call for suspected cases of STE was made online. This call was followed by a retrospective review of medical records, combined with a questionnaire to be completed by both the owner and the board‐certified neurologist who made the diagnosis. Cases were included if >50% of the seizures that occurred were related to eating and if a minimum diagnostic evaluation for seizures had been performed. Results Four cases only had STE and 6 cases had both STE and spontaneous seizures. Four of the dogs were retrievers. The most common seizure type was focal epileptic seizures evolving to become generalized. Nine dogs were diagnosed with idiopathic epilepsy. One dog had a presumptive diagnosis of glioma involving the margins of the parietal, temporal, and frontal cortex (the perisylvian region), an area known to have a key role in eating‐associated epilepsy in people. Treatment strategies included a combination of pharmacological management and eating habit changes. Conclusions and Clinical Importance We have identified a form of reflex epilepsy in dogs, with STE behavior. Further studies are warranted to improve the characterization and management of STE.
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Affiliation(s)
- Josep Brocal
- Wear Referrals Veterinary Hospital, Stockton-on-Tees, UK
| | | | - Gemma Wamsley
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Neston, UK
| | | | - Paul Mandigers
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, The Netherlands
| | - Rodrigo Gutierrez-Quintana
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Catherine Stalin
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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3
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Novel Locus for Paroxysmal Kinesigenic Dyskinesia Mapped to Chromosome 3q28-29. Sci Rep 2016; 6:25790. [PMID: 27173777 PMCID: PMC4865737 DOI: 10.1038/srep25790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is characterized by recurrent and brief attacks of dystonia or chorea precipitated by sudden movements. It can be sporadic or familial. Proline-Rich Transmembrane Protein 2 (PRRT2) has been shown to be a common causative gene of PKD. However, less than 50% of patients with primary PKD harbor mutations in PRRT2. The aim of this study is to use eight families with PKD to identify the pathogenic PRRT2 mutations, or possible novel genetic cause of PKD phenotypes. After extensive clinical investigation, direct sequencing and mutation analysis of PRRT2 were performed on patients from eight PKD families. A genome-wide STR and SNP based linkage analysis was performed in one large family that is negative for pathogenic PRRT2 mutations. Using additional polymorphic markers, we identified a novel gene locus on chromosome 3q in this PRRT2-mutation-negative PKD family. The LOD score for the region between markers D3S1314 and D3S1256 is 3.02 and we proposed to designate this locus as Episodic Kinesigenic Dyskinesia (EKD3). Further studies are needed to identify the causative gene within this locus.
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4
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Gardella E, Becker F, Møller RS, Schubert J, Lemke JR, Larsen LHG, Eiberg H, Nothnagel M, Thiele H, Altmüller J, Syrbe S, Merkenschlager A, Bast T, Steinhoff B, Nürnberg P, Mang Y, Bakke Møller L, Gellert P, Heron SE, Dibbens LM, Weckhuysen S, Dahl HA, Biskup S, Tommerup N, Hjalgrim H, Lerche H, Beniczky S, Weber YG. Benign infantile seizures and paroxysmal dyskinesia caused by an SCN8A mutation. Ann Neurol 2016; 79:428-36. [PMID: 26677014 DOI: 10.1002/ana.24580] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 12/02/2015] [Accepted: 12/13/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Benign familial infantile seizures (BFIS), paroxysmal kinesigenic dyskinesia (PKD), and their combination-known as infantile convulsions and paroxysmal choreoathetosis (ICCA)-are related autosomal dominant diseases. PRRT2 (proline-rich transmembrane protein 2 gene) has been identified as the major gene in all 3 conditions, found to be mutated in 80 to 90% of familial and 30 to 35% of sporadic cases. METHODS We searched for the genetic defect in PRRT2-negative, unrelated families with BFIS or ICCA using whole exome or targeted gene panel sequencing, and performed a detailed cliniconeurophysiological workup. RESULTS In 3 families with a total of 16 affected members, we identified the same, cosegregating heterozygous missense mutation (c.4447G>A; p.E1483K) in SCN8A, encoding a voltage-gated sodium channel. A founder effect was excluded by linkage analysis. All individuals except 1 had normal cognitive and motor milestones, neuroimaging, and interictal neurological status. Fifteen affected members presented with afebrile focal or generalized tonic-clonic seizures during the first to second year of life; 5 of them experienced single unprovoked seizures later on. One patient had seizures only at school age. All patients stayed otherwise seizure-free, most without medication. Interictal electroencephalogram (EEG) was normal in all cases but 2. Five of 16 patients developed additional brief paroxysmal episodes in puberty, either dystonic/dyskinetic or "shivering" attacks, triggered by stretching, motor initiation, or emotional stimuli. In 1 case, we recorded typical PKD spells by video-EEG-polygraphy, documenting a cortical involvement. INTERPRETATION Our study establishes SCN8A as a novel gene in which a recurrent mutation causes BFIS/ICCA, expanding the clinical-genetic spectrum of combined epileptic and dyskinetic syndromes.
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Affiliation(s)
- Elena Gardella
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Institute of Regional Health Research, University of South Denmark, Odense, Denmark
| | - Felicitas Becker
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Rikke S Møller
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Institute of Regional Health Research, University of South Denmark, Odense, Denmark
| | - Julian Schubert
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes R Lemke
- Institute of Human Genetics, University Hospitals, University of Leipzig, Leipzig, Germany
| | | | - Hans Eiberg
- RC-LINK, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nothnagel
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Holger Thiele
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Steffen Syrbe
- Department of Woman and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Andreas Merkenschlager
- Department of Woman and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | | | | | - Peter Nürnberg
- Cologne Center for Genomics, University of Cologne, Cologne, Germany
| | - Yuan Mang
- Wilhelm Johannsen Center for Functional Genome Research, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Pia Gellert
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark
| | - Sarah E Heron
- Epilepsy Research Program, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Leanne M Dibbens
- Epilepsy Research Program, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Sarah Weckhuysen
- Neurogenetics Group, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | | | - Saskia Biskup
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Niels Tommerup
- Wilhelm Johannsen Center for Functional Genome Research, Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Helle Hjalgrim
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Institute of Regional Health Research, University of South Denmark, Odense, Denmark
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Sándor Beniczky
- Danish Epilepsy Center-Filadelfia, Dianalund, Denmark.,Department of Clinical Neurophysiology, Aarhus University, Aarhus, Denmark
| | - Yvonne G Weber
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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Black V, Garosi L, Lowrie M, Harvey RJ, Gale J. Phenotypic characterisation of canine epileptoid cramping syndrome in the Border terrier. J Small Anim Pract 2013; 55:102-7. [PMID: 24372194 PMCID: PMC4277704 DOI: 10.1111/jsap.12170] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To characterise the phenotype of Border terriers suspected to be affected by canine epileptoid cramping syndrome and to identify possible contributing factors. METHODS Owners of Border terriers with suspected canine epileptoid cramping syndrome were invited to complete an online questionnaire. The results of these responses were collated and analysed. RESULTS Twenty-nine Border terriers were included. Most affected dogs had their first episode before 3 years of age (range: 0·2 to 7·0 years). The majority of episodes lasted between 2 and 30 minutes (range: 0·5 to 150 minutes). The most frequent observations during the episodes were difficulty in walking (27 of 29), mild tremor (21 of 29) and dystonia (22 of 29). Episodes most frequently affected all four limbs (25 of 29) and the head and neck (21 of 29). Borborygmi were reported during episodes in 11 of 29 dogs. Episodes of vomiting and diarrhoea occurred in 14 of 29, with 50% of these being immediately before or after episodes of canine epileptoid cramping syndrome (7 of 14). Most owners (26 of 29) had changed their dog's diet, with approximately 50% (14 of 26) reporting a subsequent reduction in the frequency of episodes. CLINICAL SIGNIFICANCE This study demonstrates similarities in the phenotype of canine epileptoid cramping syndrome to paroxysmal dystonic choreoathetosis, a paroxysmal dyskinesia reported in humans. This disorder appears to be associated with gastrointestinal signs in some dogs and appears at least partially responsive to dietary adjustments.
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Affiliation(s)
- V Black
- Davies Veterinary Specialists, Higham Gobion
| | - L Garosi
- Davies Veterinary Specialists, Higham Gobion
| | - M Lowrie
- Davies Veterinary Specialists, Higham Gobion
| | - R J Harvey
- Department of Pharmacology, UCL School of Pharmacy, London
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6
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van Strien TW, van Rootselaar AF, Hilgevoord AAJ, Linssen WHJP, Groffen AJA, Tijssen MAJ. Paroxysmal kinesigenic dyskinesia: cortical or non-cortical origin. Parkinsonism Relat Disord 2012; 18:645-8. [PMID: 22464846 DOI: 10.1016/j.parkreldis.2012.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 03/04/2012] [Accepted: 03/08/2012] [Indexed: 11/29/2022]
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is characterized by involuntary dystonia and/or chorea triggered by a sudden movement. Cases are usually familial with an autosomal dominant inheritance. Hypotheses regarding the pathogenesis of PKD focus on the controversy whether PKD has a cortical or non-cortical origin. A combined familial trait of PKD and benign familial infantile seizures has been reported as the infantile convulsions and paroxysmal choreoathetosis (ICCA) syndrome. Here, we report a family diagnosed with ICCA syndrome with an Arg217STOP mutation. The index patient showed interictal EEG focal changes compatible with paroxysmal dystonic movements of his contralateral leg. This might support cortical involvement in PKD.
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Affiliation(s)
- Teun W van Strien
- Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
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7
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Espeche A, Cersosimo R, Caraballo RH. Benign infantile seizures and paroxysmal dyskinesia: A well-defined familial syndrome. Seizure 2011; 20:686-91. [DOI: 10.1016/j.seizure.2011.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 06/27/2011] [Accepted: 06/27/2011] [Indexed: 11/29/2022] Open
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8
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Harcourt-Brown T. Anticonvulsant responsive, episodic movement disorder in a German shorthaired pointer. J Small Anim Pract 2008; 49:405-7. [PMID: 18631228 DOI: 10.1111/j.1748-5827.2008.00540.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An episodic movement disorder is described in a young German shorthaired pointer. Movement disorders are rare, but well-described, neurological conditions in human beings. An attempt is made to classify this disorder using current human guidelines. Unlike previously described movement disorders in dogs, this case responded very well to two commonly used anticonvulsant therapies, suggesting that trial therapy with these drugs is worthwhile in similar cases.
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Affiliation(s)
- T Harcourt-Brown
- Department of Veterinary Medicine, Queens Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
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9
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Jokinen T, Metsähonkala L, Bergamasco L, Viitmaa R, Syrjä P, Lohi H, Snellman M, Jeserevics J, Cizinauskas S. Benign Familial Juvenile Epilepsy in Lagotto Romagnolo Dogs. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb02991.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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Kato N, Sadamatsu M, Kikuchi T, Niikawa N, Fukuyama Y. Paroxysmal kinesigenic choreoathetosis: from first discovery in 1892 to genetic linkage with benign familial infantile convulsions. Epilepsy Res 2006; 70 Suppl 1:S174-84. [PMID: 16901678 DOI: 10.1016/j.eplepsyres.2006.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Revised: 01/07/2006] [Accepted: 02/06/2006] [Indexed: 10/24/2022]
Abstract
Paroxysmal kinesigenic choreoathetosis (PKC) is presently clearly designated as a familial movement disorder with autosomal dominant inheritance. We identified a family of PKC, in which 6 out of 23 members were affected, and 4 of the affected members had a history of infantile convulsions. Thus, this family was also considered as a case of infantile convulsions with paroxysmal choreoathetosis (ICCA). Video-EEG monitoring of two affected members suggested that PKC is less likely to be a form of reflex epilepsy, despite the existence of a history of infantile convulsions. Linkage analysis on eight Japanese families, including this family, defined the locus of PKC within the pericentromeric region of chromosome 16. ICCA and a form of autosomal dominant benign familial infantile convulsions (BFIC) were both mapped to the same or nearby region for PKC on chromosome 16. Additionally and quite unexpectedly, the locus of wet/dry ear wax (cerumen) was found to be located in the same region. Lastly, it was pointed out that the priority of the first discovery of PKC in the world should go to a Japanese psychiatrist, Shuzo Kure (1865-1932), who published the first detailed and almost complete description of a male patient with PKC in a Japanese medical journal in 1892.
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Affiliation(s)
- Nobumasa Kato
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.
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11
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Akiyama T, Ohtsuka Y, Kobayashi K, Oka E. Kinesigenic attacks with ictal electroencephalographic abnormalities. Pediatr Neurol 2004; 31:357-9. [PMID: 15519119 DOI: 10.1016/j.pediatrneurol.2004.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2003] [Accepted: 05/10/2004] [Indexed: 11/20/2022]
Abstract
We report on a 14-year 5-month-old male who had attacks similar to those of paroxysmal kinesigenic choreoathetosis. The attacks were elicited exclusively by sudden movements. On several occasions, these attacks were immediately followed by loss of consciousness or a seizure. Ictal electroencephalograms of his attacks without loss of consciousness or a seizure indicated 1.5-3.0 Hz activity in the left hemisphere. A small dosage of carbamazepine was remarkably effective in stopping the attacks. This case demonstrates that a thorough ictal electroencephalographic examination is indispensable for clarifying the pathophysiology of kinesigenic attacks. The relationship between paroxysmal kinesigenic choreoathetosis and supplementary motor area seizures is also discussed.
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Affiliation(s)
- Tomoyuki Akiyama
- Department of Child Neurology, Okayama University Medical School, Okayama, Japan
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12
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Sechi G, Corda D, Deiana GA, Contu S, Rosati G. Carbamazepine, clonazepam and focal reflex proprioceptive seizures. Clin Neuropharmacol 2004; 26:327-30. [PMID: 14646614 DOI: 10.1097/00002826-200311000-00013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We studied a 34-year-old man with focal tonic-clonic seizures sometimes elicited by some active postures of the right hand and evolving at times to secondary generalization. Treatment with carbamazepine (CBZ) in combination with parenteral diazepam induced both a dramatic increase of focal reflex proprioceptive seizures and choreoathetoid dyskinesias in the affected hand. CBZ was withdrawn and clonazepam (CZP) given 2 mg daily, with complete relief of seizures and choreoathetoid dyskinesias. CZP had a suppressive effect on seizures for over 15 years, without development of tolerance.
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Affiliation(s)
- GianPietro Sechi
- Department of Neurology, University of Sassari, Neurological Clinic, Viale S. Pietro 10, 07100-Sassari, Italy.
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13
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Abstract
Lethargic mutant mice carry a mutation in the CCHB4 gene, which encodes the beta4 subunit of voltage-regulated calcium channels. These mutants have been shown to display a complex neurobehavioral phenotype that includes EEG discharges suggestive of absence epilepsy, chronic ataxia, and hypoactivity. The current studies demonstrate a fourth element of their phenotype, consisting of transient attacks of severe dyskinetic motor behavior. These attacks can be triggered by specific environmental and chemical influences, particularly those that stimulate locomotor activity. Behavioral and EEG analyses indicate that the attacks do not reflect motor epilepsy, but instead resemble a paroxysmal dyskinesia. The lethargic mutants provide additional evidence that calcium channelopathies can produce paroxysmal dyskinesias and provide a novel model for studying this unusual movement disorder.
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14
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Spacey SD, Valente EM, Wali GM, Warner TT, Jarman PR, Schapira AHV, Dixon PH, Davis MB, Bhatia KP, Wood NW. Genetic and clinical heterogeneity in paroxysmal kinesigenic dyskinesia: evidence for a third EKD gene. Mov Disord 2002; 17:717-25. [PMID: 12210861 DOI: 10.1002/mds.10126] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is characterised by paroxysms of choreic, dystonic, ballistic, or athetoid movements. The attacks typically last seconds to minutes in duration and are induced by sudden voluntary movement. PKD loci have been identified on chromosome 16. We present the clinical and genetic details of two British and an Indian family with PKD. Linkage to the PKD loci on chromosome 16 has been excluded in one of these families, providing evidence for a third loci for PKD. Detailed clinical descriptions highlight the presence of both adolescent and infantile seizures in some of the PKD families. This study attempts to clarify the relationship of adolescent and infantile seizures to PKD and provides evidence that PKD is both genetically and clinically heterogeneous.
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Affiliation(s)
- Sian D Spacey
- Department of Molecular Pathogenesis, Institute of Neurology, University College London, London, United Kingdom
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15
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Iriarte J, Sánchez-Carpintero R, Schlumberger E, Narbona J, Viteri C, Artieda J. Gait epilepsy. A case report of gait-induced seizures. Epilepsia 2001; 42:1087-90. [PMID: 11554899 DOI: 10.1046/j.1528-1157.2001.0420081087.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Reflex epilepsy includes a group of epileptic syndromes in which seizures are induced by a stimulus, either simple (visual, somatosensory, olfactory, auditory) or more complex (e.g., eating, thinking, reading). We document a case of reflex epilepsy in which focal seizures are triggered exclusively by gait. The patient is a young boy whose walking was impaired by abnormal motor phenomena on the left side. These phenomena were elicited by gait and were accompanied by a distinctive ictal pattern with centro-temporal discharges. After comparing this patient with others reported in the literature, we determined that he has an unusual type of reflex epilepsy for which we coined the term "gait epilepsy." This disorder must be considered when physicians are making a differential diagnosis in patients who have symptoms that suggest paroxysmal kinesigenic dystonia (PKD) or selective epileptic gait disorder.
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MESH Headings
- Cerebral Cortex/physiopathology
- Child, Preschool
- Diagnosis, Differential
- Dystonia/diagnosis
- Electroencephalography/statistics & numerical data
- Epilepsy, Reflex/diagnosis
- Epilepsy, Reflex/etiology
- Epilepsy, Reflex/physiopathology
- Functional Laterality/physiology
- Gait/physiology
- Gait Disorders, Neurologic/diagnosis
- Gait Disorders, Neurologic/physiopathology
- Humans
- Magnetic Resonance Imaging/statistics & numerical data
- Male
- Monitoring, Ambulatory/statistics & numerical data
- Terminology as Topic
- Tomography, Emission-Computed, Single-Photon/statistics & numerical data
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Affiliation(s)
- J Iriarte
- Department of Neurology, Clínica Universitaria, University of Navarra, Pamplona, Spain.
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16
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Perniola T, Margari L, de Iaco MG, Presicci A, Ventura P, Ferrannini E, Illiceto G. Familial paroxysmal exercise-induced dyskinesia, epilepsy, and mental retardation in a family with autosomal dominant inheritance. Mov Disord 2001; 16:724-30. [PMID: 11481699 DOI: 10.1002/mds.1117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Only few sporadic and familial cases of paroxysmal exercise-induced dyskinesia (PED) have been described in literature. PED associated with familial epilepsy has been rarely reported. We describe a family in which six members in different generations were affected by a long-lasting PED, with childhood onset in five cases. Fasting and stress were also precipitating factors. All the subjects, moreover, showed epileptic seizures during childhood and adolescence. In addition, in all cases a condition of mild mental retardation was also documented, associated in some cases, with irritable and impulsive behaviour. Clinical, neurophysiological, neuroimaging and neuropsychological findings were reported. The homogeneous recurrence of this particular clinical picture in members of three generations emphasised a common genetic basis. In our patients, PED is transmitted as an autosomal dominant trait, with age-dependent penetrance, without evidence of genetic anticipation. The neurophysiological findings suggest a condition of hyperexcitability in the muscular and brain membrane, due to a ion channels disorder.
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Affiliation(s)
- T Perniola
- Department of Neurological and Psychiatric Sciences, Child Neuropsychiatric Service, University of Bari, Bari, Italy.
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17
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Abstract
Dyskinesias are disorders of the central nervous system that result in involuntary movements in a fully conscious individual. This report describes a disorder in a five-year-old male neutered bichon frise characterised by episodic involuntary skeletal muscle activity with normal levels of consciousness that bears some similarity to the previously described movement disorder in boxer puppies and to the human condition descriptively referred to as paroxysmal dystonic choreoathetosis. The disorder was differentiated from partial motor seizure activity by the character of the episodes, absence of identifiable preceding aura, absence of autonomic signs and the fact that multiple limbs were affected in a varying pattern without generalisation and loss of consciousness. Movement disorders are a well documented group of disorders in human neurology, but only rarely described in the veterinary literature. The purpose of this report is to contribute to an increased awareness of movement disorders within veterinary practice.
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Affiliation(s)
- J Penderis
- Animal Health Trust, Kentford, Newmarket
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18
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Abstract
The paroxysmal dyskinesias are a subset of the hyperkinetic movement disorders characterized by their episodic nature. Classification based on precipitating factors is helpful in considering treatment and prognosis. The clinical similarities with partial seizures are discussed. An approach to differential diagnosis, diagnostic evaluation, and treatment options are presented.
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Affiliation(s)
- B L Schlaggar
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
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19
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Szepetowski P, Rochette J, Berquin P, Piussan C, Lathrop GM, Monaco AP. Familial infantile convulsions and paroxysmal choreoathetosis: a new neurological syndrome linked to the pericentromeric region of human chromosome 16. Am J Hum Genet 1997; 61:889-98. [PMID: 9382100 PMCID: PMC1715981 DOI: 10.1086/514877] [Citation(s) in RCA: 234] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Benign infantile familial convulsions is an autosomal dominant disorder characterized by nonfebrile seizures, with the first attack occurring at age 3-12 mo. It is one of the rare forms of epilepsy that are inherited as monogenic Mendelian traits, thus providing a powerful tool for mapping genes involved in epileptic syndromes. Paroxysmal choreoathetosis is an involuntary-movement disorder characterized by attacks that occur spontaneously or are induced by a variety of stimuli. Classification is still elusive, and the epileptic nature of this movement disorder has long been discussed and remains controversial. We have studied four families from northwestern France in which benign infantile convulsions was inherited as an autosomal dominant trait together with variably expressed paroxysmal choreoathetosis. The human genome was screened with microsatellite markers regularly spaced, and strong evidence of linkage for the disease gene was obtained in the pericentromeric region of chromosome 16, with a maximum two-point LOD score, for D16S3133, of 6.76 at a recombination fraction of 0. Critical recombinants narrowed the region of interest to a 10-cM interval around the centromere. Our study provides the first genetic evidence for a common basis of convulsive and choreoathetotic disorders and will help in the understanding and classification of paroxysmal neurological syndromes.
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Affiliation(s)
- P Szepetowski
- The Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom
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