Petrović, Igor N. (7004083314)Igor N. (7004083314)PetrovićKresojević, Nikola (26644117100)Nikola (26644117100)KresojevićGanos, Christos (37101265800)Christos (37101265800)GanosSvetel, Marina (6701477867)Marina (6701477867)SvetelDragašević, Nataša (59157743200)Nataša (59157743200)DragaševićBhatia, Kailash P. (25958636400)Kailash P. (25958636400)BhatiaKostić, Vladimir S. (57189017751)Vladimir S. (57189017751)Kostić2025-07-022025-07-022014https://doi.org/10.1002/mdc3.12035https://www.scopus.com/inward/record.uri?eid=2-s2.0-85050501763&doi=10.1002%2fmdc3.12035&partnerID=40&md5=b4c777fda93942ffb947f97733383258https://remedy.med.bg.ac.rs/handle/123456789/13603Geste antagonistes are usually considered typical of primary dystonia, although rarely they have been described in secondary/heredodegenerative dystonias. We have recently come across a particular geste antagoniste in 5 of 10 patients with pantothenate kinase-associated neurodegeneration (PKAN) who had prominent oromandibular involvement with severe jaw-opening dystonia. It consists of touching the chin with both hands characteristically clenched into a fist with flexion at the elbows. Because of the resemblance of this geste antagoniste with the praying-like posture of Mantis religiosa, we coined the term “mantis sign.” Reviewing videos of PKAN cases in literature, including what is considered the first cinematic depiction of a case of this disorder, 3 additional cases with akin maneuvers were identified. In contrast, examining 205 videos of non-PKAN dystonic patients from our database for the presence of a similar maneuver was unrevealing. Thus, we consider the mantis sign to be quite typical of PKAN and propose it to be added as a clinical hint toward diagnosis. © 2014 International Parkinson and Movement Disorder Society.dystoniageste antagonistePKAN