question: Q:A 9-year-old girl is brought to the physician by her father because of abnormal movements of her limbs for 4 days. She has had involuntary nonrhythmic movements of her arms and legs, and has been dropping drinking cups and toys. The symptoms are worse when she is agitated, and she rarely experiences them while sleeping. During this period, she has become increasingly irritable and inappropriately tearful. She had a sore throat 5 weeks ago. Her temperature is 37.2°C (99°F), pulse is 102/min, respirations are 20/min, and blood pressure is 104/64 mm Hg. Examination shows occasional grimacing with abrupt purposeless movements of her limbs. Muscle strength and muscle tone are decreased in all extremities. Deep tendon reflexes are 2+ bilaterally. She has a wide-based and unsteady gait. When the patient holds her arms in extension, flexion of the wrists and extension of the metacarpophalangeal joints occurs. When she grips the physician's index and middle fingers with her hands, her grip increases and decreases continuously. The remainder of the examination shows no abnormalities. Which of the following is the most likely underlying cause of these findings?? 
  {'A': 'Cerebral viral infection', 'B': 'Tumor in the posterior fossa', 'C': 'Antibody cross-reactivity', 'D': 'Trinucleotide repeat mutation', 'E': 'Autosomal recessive genetic mutation\n"'},