Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia

<p><strong>Background </strong> Paroxysmal kinesigenic dyskinesia (PKD) is a disorder characterized by recurrent and brief dystonic or choreoathetoid attacks that are induced by sudden voluntary movement with highly clinical and genetic heterogeneity. We aimed to investigate the...

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Main Authors: Wo-tu TIAN, Xiao-jun HUANG, Jun-yi SHEN, Yang-qi XU, Sheng-di CHEN, Li CAO
Format: Article
Language:English
Published: Tianjin Huanhu Hospital 2017-07-01
Series:Chinese Journal of Contemporary Neurology and Neurosurgery
Subjects:
Online Access:http://www.cjcnn.org/index.php/cjcnn/article/view/1629
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author Wo-tu TIAN
Xiao-jun HUANG
Jun-yi SHEN
Yang-qi XU
Sheng-di CHEN
Li CAO
author_facet Wo-tu TIAN
Xiao-jun HUANG
Jun-yi SHEN
Yang-qi XU
Sheng-di CHEN
Li CAO
author_sort Wo-tu TIAN
collection DOAJ
description <p><strong>Background </strong> Paroxysmal kinesigenic dyskinesia (PKD) is a disorder characterized by recurrent and brief dystonic or choreoathetoid attacks that are induced by sudden voluntary movement with highly clinical and genetic heterogeneity. We aimed to investigate the clinical features of PKD in a large Chinese population.<strong> Methods</strong> One hundred and ninety five patients diagnosed as primary PKD were recruited. For all of the participants, neurological examinations were conducted and clinical manifestations were recorded and summarized in self - made uniform registration form for PKD patients. Clinical characteristics were statistically analyzed and compared between familial and sporadic PKD patients.  <strong>Results </strong> Among all of the 195 PKD patients in the present study, the gender ratio was 4.42∶1 (male∶ female). The average age of onset was (12.32 ± 3.49) years. There were 162 patients (83.08%) manifestated with pure form and 33 (16.92%) with complicated form of PKD. Among them 16 patients (8.21%) had essential tremor (ET), and 144 patients (73.85% ) had premonitory symptom. The percentage of patients manifested as dystonia, chorea and mixed form during episodic attacks were 68.72% (134/195), 4.10% (8/195) and 27.18% (53/195) repectively. There were 134 cases (68.72% ) had facial involvement. It was recorded that 115 (58.97%), 54 (27.69%) and 26 (13.33%) patients had frequency of attack &lt; 10 times/d, 10-20 times/d and &gt; 20-30 times/d respectively. The percentages of patients whose duration of attack &lt;10 s, 10-30 s and &gt; 30-60 s were 60% (117/195), 29.74% (58/195) and 10.26% (20/195) respectively. There were 64 patietns (32.82%) with family history of PKD and 131 (67.18%) were sporadic PKD patients. Up to 40% (78/195) of patients did not require/take medications, as they had minor clinical manifestations or concerns about the side effects of anticonvulsants. Among 117 patients (60% ) prescribed with anticonvulsants, 114 patients showed a good response, including complete control (N = 106) and partial control (N = 8), and 3 patients were nonresponsive. In comparison with sporadic PKD patients, familial PKD patients had earlier age of onset (<em>t </em>= 2.376, <em>P</em> = 0.019) and shorter duration of attack (<em>χ<sup>2</sup></em> = 7.731,<em> P</em> = 0.021) respectively. Conclusions We summarized the clinical characteristics of PKD patients in mainland China. Through the analysis of large sample data, we hope to improve and standardize the diagnosis and treatment of PKD clinically.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2017.07.006</p>
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spelling doaj.art-124cd1cb4f0e4298b3ae23a676ec7d422022-12-22T02:35:57ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312017-07-011775075121593Clinical phenotype analysis of paroxysmal kinesigenic dyskinesiaWo-tu TIAN0Xiao-jun HUANG1Jun-yi SHEN2Yang-qi XU3Sheng-di CHEN4Li CAO5Department of Neurology and Institute of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, ChinaDepartment of Neurology, North Department of Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 201801, ChinaDepartment of Neurology and Institute of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, ChinaDepartment of Neurology and Institute of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, ChinaDepartment of Neurology and Institute of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, ChinaDepartment of Neurology and Institute of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China<p><strong>Background </strong> Paroxysmal kinesigenic dyskinesia (PKD) is a disorder characterized by recurrent and brief dystonic or choreoathetoid attacks that are induced by sudden voluntary movement with highly clinical and genetic heterogeneity. We aimed to investigate the clinical features of PKD in a large Chinese population.<strong> Methods</strong> One hundred and ninety five patients diagnosed as primary PKD were recruited. For all of the participants, neurological examinations were conducted and clinical manifestations were recorded and summarized in self - made uniform registration form for PKD patients. Clinical characteristics were statistically analyzed and compared between familial and sporadic PKD patients.  <strong>Results </strong> Among all of the 195 PKD patients in the present study, the gender ratio was 4.42∶1 (male∶ female). The average age of onset was (12.32 ± 3.49) years. There were 162 patients (83.08%) manifestated with pure form and 33 (16.92%) with complicated form of PKD. Among them 16 patients (8.21%) had essential tremor (ET), and 144 patients (73.85% ) had premonitory symptom. The percentage of patients manifested as dystonia, chorea and mixed form during episodic attacks were 68.72% (134/195), 4.10% (8/195) and 27.18% (53/195) repectively. There were 134 cases (68.72% ) had facial involvement. It was recorded that 115 (58.97%), 54 (27.69%) and 26 (13.33%) patients had frequency of attack &lt; 10 times/d, 10-20 times/d and &gt; 20-30 times/d respectively. The percentages of patients whose duration of attack &lt;10 s, 10-30 s and &gt; 30-60 s were 60% (117/195), 29.74% (58/195) and 10.26% (20/195) respectively. There were 64 patietns (32.82%) with family history of PKD and 131 (67.18%) were sporadic PKD patients. Up to 40% (78/195) of patients did not require/take medications, as they had minor clinical manifestations or concerns about the side effects of anticonvulsants. Among 117 patients (60% ) prescribed with anticonvulsants, 114 patients showed a good response, including complete control (N = 106) and partial control (N = 8), and 3 patients were nonresponsive. In comparison with sporadic PKD patients, familial PKD patients had earlier age of onset (<em>t </em>= 2.376, <em>P</em> = 0.019) and shorter duration of attack (<em>χ<sup>2</sup></em> = 7.731,<em> P</em> = 0.021) respectively. Conclusions We summarized the clinical characteristics of PKD patients in mainland China. Through the analysis of large sample data, we hope to improve and standardize the diagnosis and treatment of PKD clinically.</p><p> </p><p><strong>DOI: </strong>10.3969/j.issn.1672-6731.2017.07.006</p>http://www.cjcnn.org/index.php/cjcnn/article/view/1629Movement disordersPhenotype
spellingShingle Wo-tu TIAN
Xiao-jun HUANG
Jun-yi SHEN
Yang-qi XU
Sheng-di CHEN
Li CAO
Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
Chinese Journal of Contemporary Neurology and Neurosurgery
Movement disorders
Phenotype
title Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
title_full Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
title_fullStr Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
title_full_unstemmed Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
title_short Clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
title_sort clinical phenotype analysis of paroxysmal kinesigenic dyskinesia
topic Movement disorders
Phenotype
url http://www.cjcnn.org/index.php/cjcnn/article/view/1629
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