An unusual case of action-induced jerking

A right-handed 62-year-old man developed a persistent involuntary jerky movement of the right arm when initiating movements like getting up from a chair or opening the door, persisting while the task is performed (video 1). CT head scan was normal. Elsewhere, a functional movement disorder was diagnosed. An MRI head revealed an old hemorrhage in the left supplementary motor area (SMA) (figures 1 and 2), an area involved in movement initiation and sequencing complex movements. EEG and Bereitschaftspotential were normal. A year later, he developed generalized nocturnal seizures. Misdiagnosis of an SMA stroke as a functional movement disorder has previously been reported.1

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