Paroxysmal Kinesigenic Choreoathetosis

To the Editor. —Commenting on an article by Goodenough et al1on paroxysmal kinesigenic choreoathetosis (PKC), Watson and Scott2reported a case with brain-stem atrophy shown by computed tomographic (CT) scan. They suggested that the same finding might be demonstrated in other patients suffering from the syndrome. Such atrophy was not present in two patients with PKC whom we recently observed and in whom both CT scanning and neurophysiologic tests of brain-stem functions were performed. Report of Cases. —Case 1. —For nine years, a 22-year-old man had suffered from paroxysms of dystonic flexion and extension of the leg, which sometimes involved the homolateral upper limb and the controlateral leg and caused him to fall. The attacks were usually provoked by voluntary movements. Dystonia of facial muscles caused grimacing. Consciousness and sphincter control were never lost. The patient had ten to 15 attacks per month, each lasting about