Dancing abdomen

Abstract

Case report

• 26 years old female. Para 3+0, LD in 2019
• Presented with 4 days history of involuntary abdominal movement.
• She has no abdominal pain, bloating or altered bowel movement
• She has no convulsions, headache and any drugs abuse
• She has irregular cycle, no dysuria or PV discharge

Physical examination

Looks well, not pale, jaundiced, cyanosis or lower limbs edema
Abdomen: Normal contour, involuntary rhythmic movement, no organomegally or ascites
CVS/ RS: Normal
CNS: GCS 15/15, normal motor and cranial nerves examination

Differential diagnosis:

1. Focal seizures
2. Psychomotor disorders
3. Labs: CBC: normal
4. Electrolytes: Ca+2: 8.5, NA: 131, K: 4.0
5. Abdominal US: Unremarkable
6. Management: Carbamazepine 200 mg po bd
7. Patient reviewed in the clinic after 3 days, movement were reducing. Then her medications changed to haloperidol 5 mg bd

Belly Dancer Dyskinesia

Definition: Belly Dancer Dyskinesia (BDD), also known as diaphragmatic flutter, is characterized by rhythmic, involuntary contractions of the diaphragm resulting in undulating, rhythmic movements of the abdomen resembling a belly dance.
• BDD is a rare presentation with only few cases reported in literature.
• The name was given by Ilecito G et al in 1990
1. Aetiological and therapeutical observations in a case of belly dancer’s dyskinesia. Linazasoro G, Blercom NV, Lasa A, et al. Mov
Disord. 2005; 20:251–253
2. belly dancer’s” dyskinesia. Iliceto G, Thompson PD, Day BL, et al. Mov Disord. 1990;5:15–22.

Aetiology: 

• Tardive dyskinesia
• Spinal cord trauma
• Myelitis
• Malignancy
• Vascular lesions
• Drugs
3. Van der Salm SMA, Erro R, Cordivari C, et al. Propriospinal myoclonus: clinical reappraisal and review of literature. Neurology. 2014;
83(20): 1862–1870
4. Aldabbour B, E’Leimat I, Alhayek K, et al. Recurrent belly dancer’s dyskinesia with pregnancy. Mov Disord. 2019; 12(2): 128–129

Diagnosis

• Mainly clinical diagnosis
• Work up to r/o common etiologies (i.e; Brain CT scan, EEG, EMG, electrolytes etc..)2
2. belly dancer’s” dyskinesia. Iliceto G, Thompson PD, Day BL, et al. Mov Disord. 1990; 5:15–22.

Treatment 

• Benzodiazepine
• AED (Carbamazepine and Na valproate)
5. Iliceto G, Thompson PD, Day BL, Rothwell JC, Lees AJ, Marsden CD. Diaphragmatic flutter, the moving umbilicus syndrome, and  “belly  dancer’s” dyskinesia. Mov Disord. 1990; 5(1):15–22.
6. Inghilleri M, Conte A, Frasca V, Vaudano AE, Meco G. Belly dance syndrome due to spinal myoclonus. Mov Disord. 2006; 21(3):394–396
7. Linazasoro G, Van Blercom N, Lasa A, Fernández JM, Aranzábal I. Etiological and therapeutical observations in a case of belly dancer’s dyskinesia.