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Table 1 Revised clinical diagnostic criteria for primary PKD

From: Recommendations for the diagnosis and treatment of paroxysmal kinesigenic dyskinesia: an expert consensus in China

Core symptoms:
1. Kinesigenic triggers and attacks presenting as dystonia, chorea, ballism, or a combination of them;
2. No impairment of awareness during attacks.
Supportive evidence:
1. Presence of aura;
2. Attack duration < 1 min;
3. Positive result of high-knee exercise test;
4. Good response to low-dose voltage-gated sodium channel blockers, especially carbamazepine/ oxcarbazepine.
Diseases listed in the following should be excluded:
1. Cerebrovascular disease;
2. Demyelinating disease, especially multiple sclerosis;
3. Metabolism disorders:
a. Hyperthyroidism;
b. Calcium-phosphate metabolism disorders (hypoparathyroidism, pseudoparathyroidism, parathyroid hyperthyroidism, pseudoparathyroid hyperplasia), primary familial brain calcification;
c. Glucose metabolism disorder;
d. Kernicterus
4. Brain trauma;
5. Psychological disorder.
The following red flags may indicate secondary causes or an alternative diagnosis:
1. Duration of attacks > 1 min;
2. Age of onset over 20 years;
3. Abnormalities in brain CT/MRI scanning or the presence of other neurologic/systemic problems;
4. No response to anticonvulsants;
5. Abnormal results of interictal examinations.