Case History Problem Solving: Part V General

  • Elliott M. Marcus
  • Stanley Jacobson


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.


Cranial Nerve Motor System Deep Tendon Reflex Facial Weakness General Physical Examination 
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Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Elliott M. Marcus
    • 1
    • 2
    • 3
  • Stanley Jacobson
    • 4
  1. 1.University of Massachusetts School of MedicineUSA
  2. 2.Tufts University School of MedicineUSA
  3. 3.Dept. of NeurologySt. Vincent Hospital and Fallon ClinicUSA
  4. 4.Tufts University Health Science CampusBostonUSA

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