A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder

Yasuto Kunii,1,2 Nozomu Matsuda,3 Hirooki Yabe1 1Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan; 2Department of Neuropsychiatry, Aizu Medical Center, School of Medicine, Fukushima Medical University, Fukushima, Japan; 3Department of Neurology, Fukus...

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Autores principales:	Kunii Y, Matsuda N, Yabe H
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Paroxysmal kinesigenic dyskinesia (PKD) anxiety disorder proline-rich transmembrane protein 2 (PRRT2) synaptosomal-associated protein 25 (SNAP25) Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/35707c1199c44c22a810c83e4e92fc7c
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spelling	oai:doaj.org-article:35707c1199c44c22a810c83e4e92fc7c2021-12-02T00:06:47ZA case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder1178-2021https://doaj.org/article/35707c1199c44c22a810c83e4e92fc7c2017-08-01T00:00:00Zhttps://www.dovepress.com/a-case-of-paroxysmal-kinesigenic-dyskinesia-which-exhibited-the-phenot-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Yasuto Kunii,1,2 Nozomu Matsuda,3 Hirooki Yabe1 1Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan; 2Department of Neuropsychiatry, Aizu Medical Center, School of Medicine, Fukushima Medical University, Fukushima, Japan; 3Department of Neurology, Fukushima Medical University School of Medicine, Fukushima, Japan Background: Paroxysmal kinesigenic dyskinesia (PKD) is a rare heritable neurologic disorder characterized by attacks of involuntary movement induced by sudden voluntary movements. No previous reports have described cases showing comorbidity with psychiatric disease or symptoms. In this case, we showed a patient with PKD who exhibited several manifestations of anxiety disorder.Case: A 35-year-old Japanese man with PKD had been maintained on carbamazepine since he was 16 years of age without any attacks. However, 10 years before this referral, he became aware of a feeling of breakdown in his overall physical functions. He had then avoided becoming familiar with people out of concern that his physical dysfunctions might be perceived in a negative light. One day he was referred by the neurologic department at our hospital to the Department of Psychiatry because of severe anxiety and hyperventilation triggered by carbamazepine. We treated with escitalopram, aripiprazole, and ethyl loflazepate. Both his subjective physical condition and objective expressions subsequently showed gradual improvement. At last, the feelings of chest compression and anxiety entirely disappeared. Accordingly, increases in plasma monoamine metabolite levels were observed, and the c.649dupC mutation, which has been found in most Japanese PKD families, was detected in his proline-rich transmembrane protein 2 gene.Conclusion: This is the first report to describe psychiatric comorbidities or symptoms in a PKD case. The efficacy of psychotropic medication used in this case, the resulting changes in plasma monoamine metabolite levels, and the recent advances in the molecular understanding of PKD suggested slight, but widespread alterations to the neurotransmitter systems in the brain. Keywords: paroxysmal kinesigenic dyskinesia, anxiety disorder, proline-rich transmembrane protein 2, synaptosomal-associated protein 25Kunii YMatsuda NYabe HDove Medical PressarticleParoxysmal kinesigenic dyskinesia (PKD)anxiety disorderproline-rich transmembrane protein 2 (PRRT2)synaptosomal-associated protein 25 (SNAP25)Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 2181-2184 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Paroxysmal kinesigenic dyskinesia (PKD) anxiety disorder proline-rich transmembrane protein 2 (PRRT2) synaptosomal-associated protein 25 (SNAP25) Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Paroxysmal kinesigenic dyskinesia (PKD) anxiety disorder proline-rich transmembrane protein 2 (PRRT2) synaptosomal-associated protein 25 (SNAP25) Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kunii Y Matsuda N Yabe H A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
description	Yasuto Kunii,1,2 Nozomu Matsuda,3 Hirooki Yabe1 1Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan; 2Department of Neuropsychiatry, Aizu Medical Center, School of Medicine, Fukushima Medical University, Fukushima, Japan; 3Department of Neurology, Fukushima Medical University School of Medicine, Fukushima, Japan Background: Paroxysmal kinesigenic dyskinesia (PKD) is a rare heritable neurologic disorder characterized by attacks of involuntary movement induced by sudden voluntary movements. No previous reports have described cases showing comorbidity with psychiatric disease or symptoms. In this case, we showed a patient with PKD who exhibited several manifestations of anxiety disorder.Case: A 35-year-old Japanese man with PKD had been maintained on carbamazepine since he was 16 years of age without any attacks. However, 10 years before this referral, he became aware of a feeling of breakdown in his overall physical functions. He had then avoided becoming familiar with people out of concern that his physical dysfunctions might be perceived in a negative light. One day he was referred by the neurologic department at our hospital to the Department of Psychiatry because of severe anxiety and hyperventilation triggered by carbamazepine. We treated with escitalopram, aripiprazole, and ethyl loflazepate. Both his subjective physical condition and objective expressions subsequently showed gradual improvement. At last, the feelings of chest compression and anxiety entirely disappeared. Accordingly, increases in plasma monoamine metabolite levels were observed, and the c.649dupC mutation, which has been found in most Japanese PKD families, was detected in his proline-rich transmembrane protein 2 gene.Conclusion: This is the first report to describe psychiatric comorbidities or symptoms in a PKD case. The efficacy of psychotropic medication used in this case, the resulting changes in plasma monoamine metabolite levels, and the recent advances in the molecular understanding of PKD suggested slight, but widespread alterations to the neurotransmitter systems in the brain. Keywords: paroxysmal kinesigenic dyskinesia, anxiety disorder, proline-rich transmembrane protein 2, synaptosomal-associated protein 25
format	article
author	Kunii Y Matsuda N Yabe H
author_facet	Kunii Y Matsuda N Yabe H
author_sort	Kunii Y
title	A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
title_short	A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
title_full	A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
title_fullStr	A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
title_full_unstemmed	A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
title_sort	case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/35707c1199c44c22a810c83e4e92fc7c
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A case of paroxysmal kinesigenic dyskinesia which exhibited the phenotype of anxiety disorder

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