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Epileptic seizures presenting as motor phenomena without concomitant conscious change may be confused with one of the paroxysmal movement disorders. Conversely, the attack of paroxysmal movement disorders may be thought to be epileptic due to a number of factors, including its sudden, unpredictable, and transient nature, its response to anticonvulsants, and the premonitory sensations preceding attacks. The distinction between epilepsy and movement disorders is further confused by the reports that these two conditions frequently occur in the same families or even in the same patients. Recent studies show that a few epilepsy and paroxysmal movement disorders are "channelopathies", indicating that they may share some common pathophysiology and a possible "overlap". A good quality of history, a trial to reproduce the motor phenomena, the application of video-EEG, polysomnography, and other electrophysiological recordings, together with regular follow-up are important for differentiating these two conditions.

Objective: To detect the differences in subcortical structures between patients with paroxysmal kinesigenic dyskinesia (PKD) and normal subjects during movement preparation and execution., Methods: The PKD patients performed a movement task, in which a CUE signal (preparation) indicated the movement sequence prior to the appearance of an imperative GO signal (execution). Event-related functional magnetic resonance imaging (fMRI) and 3dDeconvolve program of AFNI were used to estimate the hemodynamic response function and to generate activation maps., Result: During movement preparation, the activated brain areas in PKD patients were less than those of normal subject, and there was no activation in basal ganglia in PKD patients. During execution, the activation was also less in PKD patients except in bilateral M1., Conclusion: During intermission, abnormalities of the brain still exist in PKD patients when during preparing or performing movement. The movement circuit in the brain displays an unusual state. The attack may be caused by reducing of inhibition in brain areas.