Introduction: A 57-year-old, right-hand dominant female presented to the emergency department striking herself with her left hand.

Case Presentation: The astute medical staff looked beyond a behavioral health etiology. A detailed history, physical examination, and workup reveals the fascinating final diagnosis.

Discussion: This case takes the reader through the differential diagnosis and systematic workup of uncontrolled limb movements with discussion of the studies which ultimately led to this patient’s diagnosis.