What is Causing Tremors in this Elderly Man’s Hand?
Question 1 Questions answered incorrectly will be highlighted. A 61-year-old right-handed man presents with involuntary twitches of his left hand. He first noticed between 6 months and 1 year ago that when he is at rest, his left hand shakes. He can stop the shaking by looking at his hand and concentrating. The shaking does not impair his activities in any way. He has no trouble holding a glass of water. There is no tremor in his right hand, and his lower extremities are not affected. He has had no trouble walking, and there have been no falls. There have been no behavioral or language changes. On examination, a tremor of the left hand is evident when the man is distracted. His handwriting is mildly tremulous. He has bilateral cogwheel rigidity with contralateral activation, which is worse on the left. His rapid alternating movements are bradykinetic on the left. Which of the following is the most likely diagnosis in this case? Epilepsy Guillain-Barré syndrome Multiple sclerosis Parkin
