BACKGROUND: Mixed movement disorder due to pathogenic variants in the ADCY5 gene (MxMD-ADCY5) is a rare condition characterized predominantly by paroxysmal involuntary choreiform movements involving the limbs, face, and neck, often accompanied by dystonia and myoclonus. Speech disturbances, delayed motor development, cognitive impairment, axial hypotonia, and episodic exacerbations of dyskinesia are also common features. Currently, treatment strategies remain limited; however, several studies indicate a beneficial effect of caffeine in the management of dyskinesia. OBJECTIVE: This clinical report aims to present a case of MxMD-ADCY5 showing a high therapeutic response to caffeine. To our knowledge, this is the first reported Ukrainian patient with this condition demonstrating dramatic improvement in paroxysmal dyskinesia after treatment with high-dose caffeine. CONCLUSIONS: In our clinical observation, administration of caffeine at a total daily dose of 600 mg resulted in significant clinical improvement in an adult patient with MxMD-ADCY5 over a follow-up period of at least 6 months. No adverse events or side effects were reported.
FörderungenTechnical University of Munich-Institute for Advanced Study Lander Free State of Bavaria under the Excellence Strategy of the Federal Government Federal Ministry of Education and Research (BMBF) German Federal Ministry of Education and Research (BMBF, Bonn, Germany) EJP RD (EJP RD Joint Transnational Call 2022) Else Kroener-Fresenius-Stiftung Charles University: Cooperation Program in Neuroscience Agency for Health Research of the Czech Republic