rare paroxysmal movement disorder paroxysmal nonkinesigenic dyskinesia true Paroxysmal nonkinesigenic dyskinesia is a hyperkinetic movement disorder characterised by mixed dystonia, choreoathetosis and dysarthria which last from a few minutes to several hours. The attacks may be triggered by emotional stress, alcohol or coffee. Attacks typically start in infancy or early childhood and can be inherited in an autosomal dominant manner associated with mutations in the myofibrillogenesis (MR-1) gene. The retained awareness and history of triggers should prevent misdiagnosis as focal seizures.