26th August 2020

A 12-year-old boy was seen in a paediatric clinic with his mother

A 12-year-old boy was seen in a paediatric clinic with his mother. Recently, the patient has been experiencing occasional muscle twitching, leg stiffness and increasing clumsiness. However, his mother denied any abnormal choreatic movements. His school performance has been declining rapidly, and his teachers noticed that his ability to think and reason has been weakening, suggesting that he has learning difficulties. Experiencing all of these symptoms, the patient often feels angry, frustrated, and at times he can be aggressive. His father was diagnosed with a similar condition when he was 45 years of age. On examination, saccadic eye movements are present. 

What is the most likely underlying diagnosis?    

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