Case History Problem Solving: Part V General

Abstract

Case 31–1: This 59-year-old, white male, married plumbing contractor, approximately 7 years prior to admission, had the onset of a tremor of the right hand occurring mainly at rest. One year prior to admission, the patient had noted progression. The tremor was now present at the wrist and shoulder in addition to the fingers. During this time, the patient had also noted a stiffness of the right leg when walking. For one year prior to admission, since an alleged back injury, he had been unable to straighten up when walking and had had to walk in a very stooped position. During the 6 months prior to admission, the patient had experienced short episodes of subjective vertigo, resulting in a tendency to fall forward.