A healthy 18-year-old girl was presented with a 3-year history of progressively worsening involuntary movement of the uvula and soft palate. The movement was repetitive and rhythmic and had an associated auditory click. Initially, the movement was voluntarily suppressible, did not occur during sleep, and was not distressing to the patient. Subsequently, the movement increased in intensity and became more difficult to suppress. It affected her swallowing and speech and often she was awake at night.
Magnetic resonance imaging of the brain was normal, with no evidence of a causative structural lesion. Results of an autoimmune work up and analysis of the cerebrospinal fluid were unremarkable. What could be the diagnosis for this patient? *This case is from Docplexus Editorial Board for Educative purpose only
