Objective: To present 2 cases of our patients with paroxysmal kinesigenic dyskinesias (PKD) , who had intolerance or ineffectiveness of carbamazepine (CBZ), and presented good control of their symptoms on lamotrigine.

Background: Paroxysmal kinesigenic dyskinesias (PKD) is a movement disorder characterized by recurrent attacks of dyskinesia triggered by voluntary movement. The attacks are usually brief, lasting from few seconds to 1 minute, with preserved consciousness. PKD may be usually successfully treated with carbamazepine (CBZ), oxcarbazepine (OXC) or topiramate. Data on lamotrigine efficacy of lamotrigine in PKD are very limited.

Methods: The 1st patient: 19-year old female with symptoms of paroxysmal kinesigenic dyskinesias lasting for 1 year was referred to our center. The patient fulfilled the clinical diagnostic criteria for PKD of Bruno et al. from 2004. The patient was initially treated with carbamazepine, and later with oxcarbazepine, but with poor tolerance and no effect. Dose up-titration was not possible. As we could not titrate up the dose of neither OXZ nor CBZ because of intolerance, we introduced lamotrigine monotherapy in the patient. The 2 nd patient: 46 year old with PKD lasting for 10 years but never diagnosed. CBZ was not introduced as the patient had liver enzymes increased. We introduced lamotrigine, with positive effect and dyskinesias reduction at doses 2x 50 mg.

Results: Lamotrigine turned out to be effective in good control of our patients’ symptoms. No problems with drug tolerance occurred in the patient.

Conclusions: We confirm that lamotrigine can be effective and well tolerated therapeutic option in paroxysmal kinesigenic dyskinesia. It can be a effective therapeutic option for patients with intolerance of CBZ or OXC or when these drugs cannot be introduced.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/paroxysmal-kinesigenic-dyskinesia-successfully-treated-with-lamotrigine-description-of-2-cases/