When I met Megan, I was worried—really worried. She was 22, and I had been asked to evaluate her tremors. Her medical history included depression, anxiety, and anorexia, yet she was functioning quite well, except for the shakes that had been getting worse and were now constant.
At first, only her hands had been involved. Later, her legs and head began shaking as well. Although she was rarely tremor-free, the shaking seemed to be worse when she was active; her legs shook when she drove a car, and her handwriting was noticeably sloppy. She wasn't sure whether her tremors were present during sleep. During our initial interview I also discovered that her symptoms weren't limited to the shakes. Several months after the tremor started, Megan began to drool, and it seemed to get worse at night. Her extremities had become stiff, and her arms didn't swing naturally when she walked. She felt dizzy and off-balance and seemed to shuffle.
