1001 A Case of Unusual Nocturnal Movements Consistent with Paroxysmal Hypnogenic Dyskinesia

Abstract Introduction Paroxysmal hypnogenic dyskinesia (PHD) is a rare subset of paroxysmal dyskinesias characterized by recurring involuntary dystonic or choreoathetoid movements that occur during sleep immediately after an arousal from sleep. These episodes often without loss consciousness trigger and lack association with epileptiform electroencephalography (EEG) activity. Report case(s) A 61-year-old male obstructive apnea compliant PAP was referred for abnormal nighttime the past 9 years. The were stereotyped posturing involving his upper extremities entire body lasting up to 15 seconds. onset events occurred invariable resulted in awakenings He denied dream enactment as well other symptoms suggestive sleep-related movement disorders parasomnias. Sleep deprived EEG demonstrated left temporal slowing wakefulness drowsiness captured typical event NREM stage II had no ictal correlate. An MRI brain unremarkable. During overnight polysomnogram, current settings found be effective, three stiffening consistent captured. awakening REM lasted less than 10 seconds each. There correlate, atonia preserved throughout. patient started on oxcarbazepine nocturnal movements, which reduced frequency 12 4 per night. Oxcarbazepine tapered discontinued due side effects incomplete control events. Genetic testing epilepsy syndromes pending. Conclusion PHD syndrome begin cause can misdiagnosed disorder. It crucial physician aware possible neurological causes disorders. Furthermore, our patient’s partial response may further support have epileptic origin although not characterized. Support (if any) Advancing Innovation Residency Education (AIRE) Pilot Program Training Grant