Examination findings

• The patient had rest tremor in his left arm and leg, and intermittently in the right arm.
• He showed mild bradykinesia in both arms.
• In addition, there was mild rigidity in his left leg.
• He had reduced arm swing bilaterally when walking.
• His facial expression was reduced.
• The left palmomental reflex was positive.
• His writing was tremulous rather than micrographic.
• The clinical history had features of essential tremor though it was asymmetrical;
  the examination was more indicative of Parkinson’s disease.

                                                                                              DaTSCAN imaging