EPILEPSY OR PAROXYSMAL KINESIGENIC CHOREOATHETOSIS

Epileptic seizures induced by sudden movement and paroxysmal kinesigen ic choreoathetosis (PKC) have often been confused in the past, owing t o the close similarity of the attacks, the equally good response to an ticonvulsants, and the frequent occurrence of epilepsy and PKC in the same family, or even in the same patient. The pathophysiology of PKC i s still unclear and its relationship with epilepsy open to discussion. The sparing of consciousness and the lack of postictal phenomena are constant features of PKC, thus differentiating this syndrome hom epile psy. We report the case of an 8-year-old boy with frequent brief tonic attacks, without loss of consciousness, triggered by sudden movement. The neurologic examination, EEG and MRI did not help to differentiate between epilepsy and PKC. Only the occurrence of a longer seizure wit h clouding of consciousness and the recording of the postictal abnorma lities on the EEG supported a diagnosis of reflex epilepsy induced by movement.