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This article includes Supplementary Video, available online at http://www.interscience.wiley.com/jpages/0885-3185/suppmat

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jws-mds.21158.mpg29048K Segment 1. Initial examination at 6 months after the onset of his illness showed left hand dystonia and athetosis. Segment 2. Examination at 12 months demonstrates worsening of dystonia, with extension to the right hemibody, oculomotor apraxia, dysphonia, and mild left cerebellar dysmetria. The tendency for spontaneous retropulsion and postural impairment are severe. Segment 3. Patient is examined during a fall-related injury at the hospital, 2 years into his illness. He is wheelchair-bound and cannot stand even with assistance. Supranuclear vertical gaze palsy is demonstrated.

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