Video electroencephalogram features of paroxysmal kinesigenic dyskinesia in children

Abstract

Objective To investigate the features and clinical significance of video electroencephalogram (VEEG) about paroxysmal kinesigenic dyskinesia (PKD) in children. Methods The clinical data of 9 children with PKD in our hospital from January 2015 to January 2017 were reviewed and analyzed.  Results Nine patients were 8 boys and one girl, with age of 6.25-15.17 years, average (7.10 ± 3.24) years, and duration 1-12 months, average (6.12 ± 2.58) months. All patients were monitored 45 times of clinical paroxysms, with duration lasting for 5-35 s, average (9.21 ± 4.35) s. Clinical manifestations included 10 times of simple choreoathetosis, 6 times of dystonia and unsteady stand, 29 times of choreoathetosis, dystonia and unsteady stand. Clinical paroxysms of all patients were induced by sudden movement, among whom 2 cases (2/9) were induced by hyperventilation and one case (1/9) by starle. Four cases (4/9) had aura such as rigidity and numbness of limbs and paraesthesia before the onset. The ictal VEEG showed normal background rhythm or was covered by a large number of motion artifacts. Abnormal signs such as epileptic discharges, background rhythm changes or local slow waves were not seen. During interictal phase, background activities were normal. Two cases (2/9) showed nonspecific abnormalities, including frontal or occipital discontinuous slow waves, one case (1/9) showed centro?temporal (Rolandic area) spikes. Five cases (5/9) were positive for proline-rich transmembrane protein 2 (PRRT2) gene.  Conclusions There may be interictal nonspecific abnormalities or epileptic discharges in VEEG of children with PKD. The clinical manifestations and synchronous VEEG during the attack period are of great significance to make clear diagnosises.

DOI: 10.3969/j.issn.1672-6731.2018.01.010