This 43-year-old woman dated the onset of her problems to 8 months previously, immediately following a complete hysterectomy, when she had two episodes of full-body convulsions, the second of which was without loss of consciousness. Since then, she has had
unremitting tremor in the head, hands, and trunk with intermittent eyelid fluttering. She has also had stuttering. The tremor and stuttering have remained unchanged and kept her from working. She had enhanced anxiety prior to the hysterectomy, mostly related to stresses at her workplace and fear from retaliation by her supervisor. She was on a long list of medications (aripiprazole, propranolol, zolpidem, hydrocodone, and alprazolam) without perceived benefits in her tremor and underlying anxiety. She admitted to headaches but denied chest or abdominal discomfort. She had noted some unusual walking and unsteadiness but had not had falls. She was highly concerned about her problem and the lack of a clear diagnosis.