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The 13 year old girl shown here was previously in good health with a very strong performance in school presented with
a two-year history of declining school performance abd decreasing cognitive ability. She also displayed increasing difficulty
with motor activities, which became apparent through her participation in sports.
Past medical history was unremarkable, with no hospitalizations, surgeries, or serious illnesses. Family history revealed
that her two siblings were in good general health. The patient's father, paternal uncle, and paternal grandmother had been
diagnosed with a movement disorder in the past.
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