A 65-year-old right-handed male has a 20-year-history of tremor predominantly limited to activities, such as writing, drawing, or holding objects. There is also head tremor. The history is significant for similar signs and symptoms in his family members. Alcohol use decreases its severity. On examination he has a rather regular tremor of approximately 8 cycles per second (Hz) with his hands extended and also on fingernose-finger maneuver. Mild regular “waviness” is seen when writing or drawing spirals.
His tone is normal although, when performing voluntary movements with one hand there is a “ratchety” quality felt in the tone of the contralateral arm. Occasional tremor is also noted in the head and voice. What is the Most likely diagnosis? What is the Next diagnostic step? What is next step in therapy? *This case is for Docplexus editorial team for educative purpose only Source: Case…
