Diaphragmatic Myoclonus Effectively Treated with Lacosamide: A Very Rare Phenomenon of Belly Dancer Syndrome

Diaphragmatic myoclonus, also called diaphragmatic flutter, has characteristic abdominal movements resembling those of a belly dancer; hence, it is also called belly dancer syndrome (BDS). BDS is characterized by high-frequency involuntary diaphragmatic contractions. BDS can occur due to a lesion anywhere in the pathway for diaphragmatic control, from the motor cortex to the neural supply to the diaphragm. Here we report a 21-year-old girl who presented with acute-onset abdominal movements of 5 days duration. Clinical examination showed abdominal jerky movements with preserved awareness. Electroencephalograms (EEG) showed polyspike wave discharges consistent with cortical myoclonus. These abdominal myoclonic jerks disappeared dramatically on treatment with lacosamide, a third-generation antiepileptic drug. There are few case reports of BDS in the literature with a cortical myoclonus origin instead of the widely described segmental myoclonus form. The case also highlights the efficacy of lacosamide in treating diaphragmatic myoclonus jerk in young adults.