We report a patient with a cervical spinal astrocytoma who presented with athetotic hand movements. We postulate that acute pain, related to a syrinx around the operative site, contributed to the athetosis. These movements occur only after protracted, severe loss of proprioception, often in conjunction with an acute, generally painful crisis. Athetotic movements can disappear without change in proprioceptive or motor deficits when pain lessens.