Objective: To present a unique case of a 7-year-old boy with episodic rocking and break-dancing movements from the last 3 years

Background: Abnormal episodic movements in young individuals are rare, with diverse possibilities. We present and discuss one such rare case.

Method: A 7-year-old boy with no other co-morbidities presented in the neurology clinic with abnormal shaking, rocking, and break-dancing type of episodic dyskinetic body movements. These movements last from a few seconds to a maximum of 2 minutes. These movements start from the right upper limb and rapidly involve the whole body, including all four limbs. During this time, the patient has no loss of consciousness, headache, frothing, or uprolling of eyeballs. But, at times, he falls due to uncontrolled body movements.

These body movements do not have any specific triggers but sometimes appear after rigorous physical activities. The patient has about seven to eight episodes per day. In between these episodes, he remains normal. He has a normal intellect and appropriate school performance. There was no family history of a similar illness.

On examination, mild choreiform movements were noted in the upper limb. MRI of the brain and blood workup for Wilson’s disease were normal. EEG also revealed a normal study.

On examination, mild choreiform movements were noted in the upper limb. MRI Brain and blood workup for Wilson’s disease was normal. EEG also revealed a normal study.

Results: A genetic test done by clinical exon sequencing suggested a pathogenic PRRT-2 gene frameshift mutation on chromosome 16, causing paroxysmal kinesogenic dyskinesia (PKD). The test also suggested PNKD mutation on chromosome 2 as a variant of uncertain significance.

The patient was started on a low dose of Carbamazepine 100 mg twice daily, significantly reducing his symptoms’ frequency

Conclusion: Paroxysmal, episodic, transient, and dyskinetic movements are present in children with rocking or shaking movements, and many times, the diagnosis is missed or remains uncertain. This boy has clinical features suggestive of PKD with a positive genetic test and responded well to the treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/episodic-rocking-movements-in-a-young-boy/