Reference no: EM133702179

Question

A 66-year-old man presents to the clinic with tremor for 6 months. He first noticed the tremor while driving and watching his left hand on the steering wheel. One month ago, he stopped driving because the tremor was bothering him too much to drive safely. The tremor is predominantly on the left side of his body. It is most severe when his hands and legs are at rest, and it seems to improve when he is moving around. He also reports that he moves slower than usual and feels stiff, making it difficult to use utensils and tools, get out of chairs, or even get out of bed. People have told him that he now speaks slower than usual. He denies headache, loss of consciousness, shortness of breath, difficulty swallowing, weight changes, changes in mood, or cognitive changes. He is able to perform all basic and instrumental activities of daily living (aside from driving). Vital signs include BP 123/77 mm Hg and HR 74 bpm. The patient's speech is slow and somewhat halting. A Mini-Mental State Examination is performed, which is normal. Neurological examination of the cranial nerves is normal. The patient's left arm and leg exhibit a resting tremor,