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Updated: Jan 17, 2026

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Published on: December 13, 2017
Clinical Reasoning: A 58-Year-Old Man With Resting Tremor, Bradykinesia, and Distal Numbness
Rafaela Costa1,2, Luís Braz1,3, Madalena Pinto1
1Department of Neurology, São João University Hospital, Porto, Portugal.
Abstract:
A 58-year-old man presented with progressive right-hand loss of dexterity and resting tremor over 2 years, accompanied by sensory symptoms in the distal extremities and chronic cough. Neurologic examination revealed asymmetric parkinsonism, distal hypoesthesia, and decreased vibratory sensation. Nerve conduction studies revealed a non-length-dependent axonal polyneuropathy. This case presents a structured approach to both parkinsonism and polyneuropathy, and the clinical reasoning necessary when dealing with multiple system involvement, in which different differential diagnoses should be considered.
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