CASE HISTORY:
A 65-year-old male, with no previously known co-morbidities presented to
the Neurology department with the complaint of tremors, slowness of
movements and occasional postural instability for the last 1 year.
According to the patient the symptoms were gradual on progression and
was increasing in intensity for the last 1-1.5 months. Moreover, the
patient also had a recent newly developed history of headache,
generalized with no any relevant aggravating or relieving factor, along
with recurrent falls for the last 3 days. There was no history of
seizure-like activities, loss of consciousness, nausea, vomiting,
paralysis/paresis. The patient had no significant past history nor any
similar family history. The vitals were normal during the arrival to the
clinic. On clinical examination, there a positive Chvostek sign was
seen. Moreover, rigidity and narrow based gait was noted. The power,
bulk and tone were normal in all 4 limbs. There was no sensory deficit
and plantar reflex was down going.