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22302.mpg12561KThe 68-year-old patient 2 months after the diagnosis of anti-Hu-neuropathy. Segment 1. Sitting at rest reveals dystonic inversion of the right foot and mild involuntary writhing of both upper extremities (chiefly distally, more pronounced on the right side). The involuntary movements increase when stretching out both arms. Segment 2. When stretching out arms dystonic posturing can be observed with a flexion of the wrist and hyperextension of the fingers. Involuntary choreoathetotic movements increase visibly when the patient closes her eyes. Note the dysmetria during finger-nose test without any intention tremor hinting to impaired kinaesthesia. Note also mild facial choreic movements. Segment 3. Tapping with the less impaired left hand renders the left arm dystonic. Tapping on the right is ataxic. Action enhances choreoathetosis and dystonia not only in the extremities involved, but also the feet. Note that the involuntary movement are distally more pronounced reflecting the distribution of proprioceptive malfunction. Segment 4. Walking is small based and unsteady with dystonic cramping of the toes. Chorea and dystonic posturing in upper extremities does not increase while walking.

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