Lesch-Nyhan disease
Apr. 30, 2024
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Functional tremor mostly of right arm, variable, distractible, and suppressible
This 38-year-old woman had a sudden onset of tremor 1 day after a motor vehicle accident, during which she suffered no injuries. The tremor, localized primarily to her right arm, has been intermittent and has fluctuated in amplitude and frequency. She is able to “control” the tremor for several minutes. The examination shows tremor in the right arm that varies in frequency and amplitude. It is markedly distractible and can be completely suppressed during contralateral voluntary movement. These features are characteristic of functional tremor. (Contributed by Dr. Joseph Jankovic.)