Paroxysmal Kinesigenic Dyskinesia Masquerading as Dissociative Disorder: A Case Report on Pseudo-Dissociation

Neurol India. 2022 Jan-Feb;70(1):390-391. doi: 10.4103/0028-3886.338710.

Abstract

Movement disorders are common presentations to psychiatry and neurology clinics in general hospitals. Many a times, liaison between psychiatry and neurology helps in determining the exact etiology and diagnosis of rare movement disorders. Paroxysmal dyskinesia is a group of disorders caused by a genetic mutation. It is one of the rare presentations among dyskinetic disorders but often encountered by psychiatrists due to the psychogenic nature of episodes and apparently normal neurological findings in-between the episodes. Liaison work with a neurologist is of great importance rather than misdiagnosing them as a dissociative or psychogenic movement disorder. Unawareness of their presentation can lead to repeated consultations, unwarranted psychotherapies, and can create a sense of therapeutic nihilism among the treating psychiatrists. Predominantly four different variants are described in the literature under this group and new classification has been proposed recently. We encountered a case of paroxysmal kinesigenic dyskinesia with obstructive sleep apnea masquerading as a dissociative disorder.

Keywords: Dissociative disorder; misdiagnosis; paroxysmal kinesigenic dyskinesia; phenytoin; psychogenic.

Publication types

  • Case Reports

MeSH terms

  • Chorea* / diagnosis
  • Dissociative Disorders / diagnosis
  • Dystonia* / diagnosis
  • Humans
  • Mutation

Supplementary concepts

  • Familial paroxysmal dystonia