Main clinical features
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early-onset tremor, dyskinesia, slowly progressive cerebellar ataxia
trembling of both hands, which was exacerbated by emotional stress and physical exercise; mild unsteadiness and ataxia of the upper limbs, especially under unusual circumstances, began at age 15 to 20 years
neurologic examination showed dysmetric saccades, disrupted ocular pursuit movements, gaze-evoked nystagmus, cerebellar dysarthria, and a high-frequency, small-amplitude tremor in both hands in most of the patients |