ABSTRACT
CASE PRESENTATION A 64-year-old woman was seen for tremor of the upper limbs, jaw, and, when anxious, ‘the entire body’. The tremor had begun at age 14, with slow worsening over the ensuing years. Her father had tremor, eventually becoming so severe that he was not able to feed himself. Many of his relatives also had tremor. Two of the patient’s siblings have tremor, but it had not been observed in her children or grandchildren. The tremor interfered with many dexterous activities such as using eating utensils, including for eating soup, writing, and her hobby of oil painting, and she used two hands to hold a cup of coffee. The tremor made her self-conscious. She had not noticed alcohol to have an effect on the tremor. At presentation she was taking primidone 250 mg twice a day, which had been helpful.
