Etiological and therapeutical observations in a case of belly dancer's dyskinesia

✍ Scribed by Mazen Jabre; Boulos-Paul Bejjani

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 37 KB
• Volume: 21
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.21028

✦ Synopsis

Linazasoro and colleagues 1 discussed the onset of a belly dancer's dyskinesias in a patient on clebopride, which favorably responded to transcutaneous electric nerve stimulation (TENS).

Clebopride is a gastrointestinal prokinetic agent with a central and enteric antidopaminergic properties. Its use may induce central neurochemical changes, which could have mediated the onset of involuntary abdominal movements and akathisia.

Abdominal dyskinesias, present only at rest and disappearing with movement, are analogous to the phenomenology we observe in periodic limb movements (PLM) during relaxed wakefulness or sleep. If our consideration is true, it would be, to our knowledge, the first clinical report of abdominal muscles involvement in PLM. Therefore, dopaminergic therapy could be tried.

Tardive dyskinesia is an alternative diagnosis. Postsynaptic dopamine-depleting agents, such as tetrabenazine and reserpine, would be of value but should be cautiously used in this patient with an active history of depression. Amantadine is a rather favored alternative or add-on treatment with a safer adverse events profile.

Clebopride-induced extrapyramidal symptoms are usually progressively reversible upon its withdrawal. 2 Hence, we expect the gradual clinical resolution of the patient's symptoms even without TENS, after the discontinuation of clebopride. On the other hand, a placebo-controlled double-blind study is warranted to confirm the effectiveness and long-term efficacy of TENS in similar focalized movement disorders, refractory to conventional medical interventions.