Alexandra Borchert, MD Gabriel Möddel, MD Matthias Schilling, MD A man presented multifocal brachiofacial or generalized dystonic movements and dyskinesias (video on the Neurology Web site at www.neurology.org). Episodes started with a variable aura, triggered by emotional stress or movement initiation. Clinical examination and diagnostics including brain MRI and EEG were normal. Attacks stopped after therapy with carbamazepine, 200 mg daily, was started. Paroxysmal dyskinesia is a rare, mostly autosomal dominant disorder characterized by kinesigenic triggers, attacks 1 minute, preserved consciousness, absence of structural diseases or epileptiform activity, and effect of phenytoin or carbamazepine.1,2 Although the term kinesigenic dyskinesia is used, other triggers are possible. The movements often include dystonic postures, with or without dyskinesias.