Belly Dancer's Dyskinesia or Functional Movement Disorder: Involuntary Abdominal Movements in a Pediatric Patient

Belly dancer's dyskinesia (BDD) is a rare movement disorder marked by involuntary, rhythmic, undulating movements of the abdominal wall, often mistaken for gastrointestinal or psychiatric conditions. We describe the case of a 13-year-old girl with a seven-year history of abdominal spasms that stopped during sleep and resumed on waking. The episodes were accompanied by loud "whooshing" sounds from the abdomen. Her medical history included primary ciliary dyskinesia and a ventricular septal defect. She had never received medication for her symptoms. On examination, the right side of her upper body twisted in sync with the abdominal movements, which lessened when she was distracted. An extensive workup including brain and spine magnetic resonance imaging (MRI), electroencephalogram (EEG), echocardiogram, and metabolic panels was unremarkable. With no clear underlying cause, a diagnosis of BDD was made. Further evaluation by a psychiatrist showed grunting and sighing, as well as trunk and shoulder flexion associated with movements suggesting a functional movement disorder (FMD). The patient was started on clonidine 0.1 mg for symptomatic relief and was referred for cognitive behavioral therapy (CBT). Although she was lost to follow-up, this case highlights the clinical overlap between BDD and FMD and the importance of considering it in patients with unexplained abdominal movements.