# Ear Dyskinesia in the Absence of Neuroleptics: A Case Report

## TL;DR

A rare case of ear dyskinesia without neuroleptic use is reported, highlighting its unusual symptoms and treatment challenges.

## Contribution

This is a rare case report of ear dyskinesia occurring without neuroleptic exposure, expanding clinical understanding of the condition.

## Key findings

- The patient exhibited non-rhythmic, unilateral ear and head muscle contractions over a year.
- Botulinum toxin treatment was ineffective, and the patient was lost to follow-up.
- No underlying pathology was found, emphasizing the need for further research on this condition.

## Abstract

Ear dyskinesia, also known as "moving ear syndrome," is a rare movement disorder characterized by involuntary, rhythmic, or semi-rhythmic contractions of the external ear muscles. The condition is not well-documented in the medical literature, with only a few case reports available. We present the case of a 37-year-old teacher from Saudi Arabia who developed a history of sudden, progressive involuntary movement of the posterior head region, provoking movement of the external ears, over the course of one year. The movements were non-rhythmical, more prominent on the right side, and associated with occasional involvement of the face and anterior neck muscles. The patient had no history of neuroleptic use or other relevant medical conditions. Examination confirmed the presence of palpable muscle contractions originating mainly from the posterior region, with the movements not synchronized across the two sides. Investigations, including blood tests and brain MRI, did not reveal any underlying pathology. A diagnosis of ear dyskinesia was made, and botulinum toxin treatment was recommended; however, the treatment showed no results, and then the patient was subsequently lost to follow-up. This case adds to the limited literature on the rare phenomenon of ear dyskinesia, highlighting the clinical presentation and the challenges in the management of this unusual movement disorder. Further research is needed to better understand the underlying mechanisms and optimal treatment approaches for this condition.