A case of mixed type of paroxysmal dyskinesia: is there an overlap between two clinical categories of paroxysmal dyskinesia?

We report a sporadic case of paroxysmal dyskinesia of predominantly choreic and ballistic movements of 10 years duration in a 22-year-old male. The movement starts after exercise for certain period. However, for the next 5-15 min, the movements are triggered by sudden voluntary activity. These dyskinesias persist for about 10-30 s after sudden voluntary activity. Patient has to be immobile once symptoms start after the exercise to prevent the kinesigenic involuntary movements. Involuntary movements could be induced in the lower limbs, upper limbs, facial and jaw muscle by local exercise. Overtime symptoms occurred with minimal exercise. Secondary dyskinesia was ruled out by investigations. Patient responded well to Carbamazepine, relapsed when stopped taking it.