Seizures and movement disorders: phenomenology, diagnostic challenges and therapeutic approaches

Abstract

Seizures and movement disorders (MDs) are distinct neurological conditions presenting with abnormal movements. Despite sharing an overlap in phenomenology, these movements have different origins. In order to explore the overlaps and the narrow boundaries between these two conditions, we performed a review of the literature to explore the risk of seizures in MDs. We discussed the mimics and chameleons including MDs that look like seizure (eg, paroxysmal dyskinesia, status dystonicus) and seizures that look like MDs (eg, epilepsia partialis continua, nocturnal frontal lobe epilepsy). Additionally, we examined the therapeutic challenges as well as the anatomical and chemical pathways relevant in the interplay between epilepsy and MDs. Finally, we proposed an algorithm to guide clinicians towards the final diagnosis of conditions characterised by the co-occurrence of MDs and seizures.

The Genetic Relationship between Paroxysmal Movement Disorders and Epilepsy

“…Paroxysmal dyskinesias have distinct features with episodic occurrences of involuntary extrapyramidal movements [3]. It is a heterogeneous disorder group characterized by episodes of abnormal involuntary movements, such as chorea, dystonia, and ballism [3]. Most of these movements do not cause loss of consciousness but sometimes a sensory aura precedes them [3].…”

“…It is a heterogeneous disorder group characterized by episodes of abnormal involuntary movements, such as chorea, dystonia, and ballism [3]. Most of these movements do not cause loss of consciousness but sometimes a sensory aura precedes them [3]. Some clinicians may mistake these movements for focal seizures, either focal aware seizure or focal impaired awareness seizure [3].…”

“…Most of these movements do not cause loss of consciousness but sometimes a sensory aura precedes them [3]. Some clinicians may mistake these movements for focal seizures, either focal aware seizure or focal impaired awareness seizure [3]. In such cases, the absence of ictal discharges in a scalp electroencephalography may be helpful in the diagnosis of paroxysmal dyskinesias [2].…”

What should a dentist be aware of concerning symptoms of sleep disorders in the oral cavity?

“…These events do not involve abnormal, rhythmic discharges of cortical neurons. Usually they are caused by either psychological or physiological conditions [16,18,20,25]. That is why nonepileptic seizures (NES) can be divided into two subtypes: organic non-epileptic seizures and psychogenic seizures.…”

“…A newer name for non-epileptic seizures is "dissociative seizures". This is helpful because it does not describe seizures in terms of epilepsy [16,18,29]. From a dental point of view, treatment should be limited to damaged teeth tissues restoration, because removal of the causative disease of NES causes seizures to cease.…”