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September 1979

Paroxysmal Dyskinesia

Author Affiliations

Neurology Research Laboratories Veterans Administration Hospital Durham, NC 27705

Arch Neurol. 1979;36(9):596. doi:10.1001/archneur.1979.00500450090023

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To the Editor.—  I would like to take issue with the article "Familial and Acquired Paroxysmal Dyskinesias" by Goodenough et al (Archives 35:827-831, 1978). The authors have proposed a new classification of familial paroxysmal dyskinesia as different from reflex epilepsy. One of the hallmarks of this differentiation is the absence of epileptic discharges, as recorded from the scalp during the paroxysm, to exclude epilepsy. At the Durham Veterans Administration Hospital, Durham, NC, Epilepsy Center, we have had experience, as have other institutions, with patients whose scalp EEG was normal during a seizure but who showed epileptic discharges from implanted depth electrodes. An unaltered scalp EEG cannot exclude a diagnosis of epilepsy. Consequently, the patient's history serves as the most reliable indicator of his condition. The histories and table of clinical characteristics the authors gave in their report argues strongly for the presence of epilepsy.Recently, there has been much interest

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