This case study investigated the consequences of cocaine use and resultant extrapyramidal motor dysfunction. The study focused on a female client, post-long-term drug abuse with concomitant untreated head trauma, experiencing extraneous motor movements of the lips, tongue, jaw, and upper and lower extremities. The goals of this study were to (a) describe the presenting features of extrapyramidal motor dysfunction and resultant orofacial dystonia in this participant, including the presence of extraneous motor movements and the impact of these movements on speech intelligibility and communication effectiveness, and (b) describe the influence of traditional speech exercises and drills on speech characteristics and the presence of extraneous motor movements in this participant. Few studies have addressed extrapyramidal motor dysfunction related to cocaine abuse specific to speech-language pathology assessment and treatment. This study offers speech-language pathologists insight into the diagnosis and treatment of individuals experiencing extrapyramidal motor dysfunction associated with cocaine abuse. (Contains 3 tables.)