ABSTRACT
A 65-year-old man presented to the emergency department in April 1999 for evaluation of possible seizures.1 He had a history of treated hypertension and treated syphilis, and he was undergoing outpatient evaluation for an aortic arch aneurysm. His chief complaint was uncontrollable shaking of his left arm and leg. The first shaking episode had occurred 1 year earlier. At that time, he was walking when he suddenly developed uncontrollable shaking of the left arm and leg. This episode lasted for a few seconds and terminated spontaneously when the patient sat down. From that point onwards, the episodes occurred intermittently, about once or twice a week. The shaking would occur only when the patient was upright and always resolved when he sat or lay down.
