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A 20-month-old boy was brought to hospital after suddenly developing uncoordinated right-sided upper and lower limb movements, with loss of balance while playing at home. He was afebrile and otherwise well apart from a mild cough, with no history of head trauma. There was no neurological family history, and no significant medical history. Neurological examination demonstrated facial symmetry, with rhythmic right-sided posterior arm movements and kicking of the right leg with normal reflexes bilaterally; however, he was still able to produce purposeful movements. The examination findings were consistent with hemiballismus hemichorea due to their unilateral nature.1 Baseline observations were normal for his age and are shown below: