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jws-mds.20842.mpg13033K Segment 1. The patient exhibits mixed involuntary movements of the face, represented by raising of the eyebrows, tongue protrusion and twisting, mouth opening, eye rolling, smiling, and blinking. She also produces coughing, sniffing, and gasping actions, which strongly resemble phonic tics. All involuntary movements are partially suppressible by volition. Segment 2. On gait examination, the patient exhibits an outward flexed dystonic posture of the right upper limb. Retropulsion is observed on the pull test. She manifests dyspraxic spatial-type errors, characterized by difficulty in imitating finger postures and body-part-as-object errors on pantomime tasks. Errors are present bilaterally, although more severe on the right side. Intransitive actions are performed normally. There is bradykinesia of both upper limbs on alternate repetitive movements. This video presentation has been abbreviated. The full version will appear on theMovementDisorders DVD Supplement, which is issued bi-annually.

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