{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:54:51Z","timestamp":1776664491922,"version":"3.51.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Paroxysmal kinesigenic dyskinesia (PKD) is a rare movement disorder characterized by brief dystonic or dyskinetic attacks precipitated by sudden voluntary movement or arousal. Pregnancy complicated by PKD is extremely rare, and evidence guiding perinatal decision-making, especially regarding delivery mode and anesthetic management remains scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a term pregnancy in a woman with long-standing PKD managed through a multidisciplinary team involving neurology, obstetrics, anesthesiology, and neonatology. Following individualized optimization of antiseizure medications (ASMs) and intensive antenatal surveillance, the patient showed moderate symptomatic improvement during pregnancy. Given the high risk of pain, stress, or movement-triggered dystonic attacks with transient loss of voluntary motor control during labor, elective cesarean delivery was planned. Combined spinal\u2013epidural anesthesia (CSEA) was performed to provide effective analgesia while minimizing arousal and sensory triggers. The procedure was uneventful, with no perioperative dystonic episodes. A healthy neonate was delivered with no congenital anomalies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates that favorable maternal and neonatal outcomes can be achieved in pregnancies complicated by PKD through individualized antiseizure medication management, multidisciplinary care, and trigger-oriented perinatal planning. The structured clinical decision-making pathway proposed in this study may provide a practical framework for managing this rare and challenging condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1795479","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:25:33Z","timestamp":1776662733000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary perinatal management of paroxysmal kinesigenic dyskinesia in pregnancy: a case report and a proposed structured pathway"],"prefix":"10.3389","volume":"13","author":[{"given":"Weimin","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Wenling Maternal and Child Health Care Hospital","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junqin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Wenling Maternal and Child Health Care Hospital","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Wenling Maternal and Child Health Care Hospital","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhimin","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wenling Maternal and Child Health Care Hospital","place":["Taizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2280","DOI":"10.1212\/01.wnl.0000147298.05983.50","article-title":"Clinical evaluation of idiopathic paroxysmal kinesigenic dyskinesia: new diagnostic criteria","volume":"63","author":"Bruno","year":"2004","journal-title":"Neurology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"069","DOI":"10.1055\/s-2001-13121","article-title":"Familial (idiopathic) paroxysmal dyskinesias: an update","volume":"21","author":"Bhatia","year":"2001","journal-title":"Semin Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1038\/ng.1008","article-title":"Exome sequencing identifies truncating mutations in PRRT2 that cause paroxysmal kinesigenic dyskinesia","volume":"43","author":"Chen","year":"2011","journal-title":"Nat Genet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.celrep.2011.11.001","article-title":"Mutations in the gene PRRT2 cause paroxysmal kinesigenic dyskinesia with infantile convulsions","volume":"1","author":"Lee","year":"2012","journal-title":"Cell Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1212\/WNL.0b013e31825f06c3","article-title":"PRRT2 mutations: a major cause of paroxysmal kinesigenic dyskinesia in the European population","volume":"79","author":"M\u00e9neret","year":"2012","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1002\/mds.28865","article-title":"TMEM151A variants cause paroxysmal Kinesigenic dyskinesia: A large-sample study","volume":"37","author":"Tian","year":"2022","journal-title":"Mov Disord"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1002\/mds.28904","article-title":"Exome-wide analyses in paroxysmal kinesigenic dyskinesia confirm TMEM151A as a novel causative gene","volume":"37","author":"Li","year":"2022","journal-title":"Mov Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"865690","DOI":"10.3389\/fneur.2022.865690","article-title":"Screening of the TMEM151A gene in patients with paroxysmal Kinesigenic dyskinesia and other movement disorders","volume":"13","author":"Ma","year":"2022","journal-title":"Front Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1002\/mds.28061","article-title":"The phenotypic and genetic spectrum of paroxysmal kinesigenic dyskinesia in China","volume":"35","author":"Huang","year":"2020","journal-title":"Mov Disord"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"361","DOI":"10.18999\/nagjms.83.2.361","article-title":"A case of paroxysmal kinesigenic dyskinesia suspected to be reflex epilepsy","volume":"83","author":"Nakayama-Kamada","year":"2021","journal-title":"Nagoya J Med Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1684\/epd.2013.0569","article-title":"Clinical and polygraphic study of familial paroxysmal kinesigenic dyskinesia with PRRT2 mutation","volume":"15","author":"Fabbri","year":"2013","journal-title":"Epileptic Disord"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/S0140-6736(99)00701-1","article-title":"Ceasing of movement-disorder attacks immediately after the onset of pregnancy: possible effect of human chorionic gonadotropin","volume":"354","author":"Madeja","year":"1999","journal-title":"Lancet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1159\/000165348","article-title":"Paroxysmal non-kinesigenic dyskinesia caused by the mutation of MR-1 in a large polish kindred","volume":"61","author":"Friedman","year":"2009","journal-title":"Eur Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.parkreldis.2020.09.017","article-title":"Clinical course of paroxysmal dyskinesias throughout pregnancy","volume":"80","author":"Bovenzi","year":"2020","journal-title":"Parkinsonism Relat Disord"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"38","DOI":"10.7453\/gahmj.2013.008","article-title":"The CARE guidelines: consensus-based clinical case reporting guideline development","volume":"2","author":"Gagnier","year":"2013","journal-title":"Glob Adv Health Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1080\/14737175.2019.1648211","article-title":"Paroxysmal movement disorders - practical update on diagnosis and management","volume":"19","author":"De Gusmao","year":"2019","journal-title":"Expert Rev Neurother"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3493","DOI":"10.1093\/brain\/awr289","article-title":"Identification of PRRT2 as the causative gene of paroxysmal kinesigenic dyskinesias","volume":"134","author":"Wang","year":"2011","journal-title":"Brain"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1523\/JNEUROSCI.4945-06.2007","article-title":"Neurosteroid synthesis-mediated regulation of GABA(A) receptors: relevance to the ovarian cycle and stress","volume":"27","author":"Maguire","year":"2007","journal-title":"J Neurosci"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.nbd.2014.06.010","article-title":"Neurosteroids and their role in sex-specific epilepsies","volume":"72","author":"Reddy","year":"2014","journal-title":"Neurobiol Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s40035-021-00231-8","article-title":"Recommendations for the diagnosis and treatment of paroxysmal kinesigenic dyskinesia: an expert consensus in China","volume":"10","author":"Cao","year":"2021","journal-title":"Transl Neurodegener"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/S1474-4422(25)00130-9","article-title":"Management of reproductive risks in people with epilepsy","volume":"24","author":"Bj\u00f8rk","year":"2025","journal-title":"Lancet Neurol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1684\/epd.2019.1105","article-title":"Management of epilepsy in pregnancy: a report from the international league against epilepsy task force on women and pregnancy","volume":"21","author":"Tomson","year":"2019","journal-title":"Epileptic Disord"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1795479\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:25:34Z","timestamp":1776662734000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1795479\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":22,"alternative-id":["10.3389\/fmed.2026.1795479"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1795479","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,20]]},"article-number":"1795479"}}