ABSTRACT
CASE PRESENTATION A 53-year-old man presented with episodic ligh-theadedness for 2 years. The episodes occurred whenever he was exposed to temperatures > 85°F and were exacerbated by exercising or golf. With the light-headedness he also experienced nausea, frequent urination, erectile dysfunction, shallow breathing, and palpitations. The episodes lasted a day. One year after the episodes started he developed urinary frequency, nocturia, and incontinence, and 6 months later he developed a shuffling gait and hypophonia followed by micrographia. He had a history of gout but no other medical problems. There was no family history of similar illness. He worked as a supervisory engineer but had no relevant environmental exposure.
