History

• Female, 65 years.
• The patient presented with a history of 18 months of tremor.
• This affected the right arm more than the left, and was worse when cooking.
• She had unsteadiness when walking.
• She was using a Salbutamol nebuliser for Chronic Obstructive Pulmonary disease.
• The patient suffered from hypothyroidism; her T4 was normalised with no effect on her tremor.
• Alcohol had no effect on her tremor.