A 19-year-old man with cerebral palsy developed jerky tremor and abnormal posture of the head.

This young man had a history of microcephaly, developmental delay, static encephalopathy, spastic quadriparesis, and complex partial seizures with secondary generalization. Neuroimaging studies showed left hemispheric atrophy, diffuse ventricular enlargement, and cerebellar atrophy. On examination, he had intermittent head turning to the right representing cervical dystonia with a dystonic tremor component. He received botulinum toxin injections into both sternocleidomastoid muscles, right and left splenius capitis muscles, left levator scapula, and right cervical trapezius.