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A 57-Year-Old Woman With Progressive Left Hand Clumsiness and Falls
Vijayashankar Paramanandam1, Diana Angelika Olszewska1, Bhattacharjee Shakya2
1Centre for Brain Health Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland.
Clinical History:
A 57-year old woman presented with left hand pain, periodic leg movement during sleep, gradual onset of stiffness, clumsiness, and falls. Neurological examination showed: generalized rigidity and bradykinesia. There was left hand dystonic posturing and ideomotor apraxia, as well as mirror movements of upper limbs and stimulus-sensitive myoclonus. The patient had a high-pitched voice and hypophonia (Video S1).
Discussion:
Experts discuss localization and the syndromic diagnosis and predict the underlying pathology. The pathological diagnosis is then provided and clinical learning points are considered.
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