Paroxysmal exercise induced dystonia is a rare disorder classified as one of the paroxysmal dyskinesias.1 2 In this condition patients develop dystonia, mostly involving their feet, after prolonged exercise, usually walking or swimming.1-3Treatment response is poor to both antieplileptic drugs and drugs given for dystonia—for example, anticholinergic drugs, muscle relaxants, or acetazolamide.3

We recently noted the dramatic benefit of unilateral pallidotomy in completely abolishing attacks of paroxysmal exercise induced dystonia of the contralateral foot in one patient.

This 47 year old woman was followed up over 2 years for a 10 year history of attacks of dystonia affecting her right foot, induced by exercise. At onset the attacks were mild and were induced by walking long distances. During an attack her right foot would invert for a few minutes making it difficult for her to continue walking or stand. The attack would subside within 2–3 minutes on resting. …