Snapshot A 63-year-old male is brought to the physician by his wife for the evaluation of a tremor. The tremor is worse at rest, and decreases in severity with purposeful movement. The patient reports to having difficulty with initiating voluntary movement, and his wife states that the patient’s movements have been slow. On exam, there is seborrheic dermatosis on the nasolabial folds. There is a “pill-rolling” resting tremor accentuated when the patient is asked to perform mental calculations. Resistance to passive movement at the elbow joint is noted. On gait testing, there was difficulty with initiating gait, as well as the patient taking short steps when walking forward. Introduction Neurodegenerative progressive movement disorder login to view 7 more bullets Pathophysiology login to view 6 more bullets Secondary parkinsonism login to view 12 more bullets Presentation Symptoms login to view 11 more bullets Evaluation Clinical diagnosis Histology login to view 3 more bullets Differential Lewy body dementia Alzheimer's disease Essential tremor Parkinson-plus syndromes login to view 3 more bullets Drug-induced parkinsonism Treatment Pharmacologic treatment login to view 11 more bullets Surgical treatment login to view 3 more bullets Prognosis, Prevention, and Complications Prognosis login to view 2 more bullets Prevention login to view 1 more bullet Complications login to view 5 more bullets