ABSTRACT
CASE PRESENTATION A 47-year-old African-American woman had developed mild vertigo 5 years ago. It was intermittent initially, and gradually became more constant after about a year. At the same time she noticed slurred speech, diplopia, and micrographic, tremulous handwriting. Over the next year she developed progressive loss of balance, tremor in both hands, which was worse with activity, and impaired mobility. It was more difficult to arise from a chair and get out of the car. She experienced transient dysphagia, which resolved. Her family noted a dramatic change in personality; she became less motivated and less interactive. The family history is negative for any neurological or psychiatric disease.
