23rd August 2024

A 68-year-old female presents to A&E following a fall at home. A hip X-ray does not show any signs of a fracture

A 68-year-old female presents to A&E following a fall at home. A hip X-ray does not show any signs of a fracture and the patient is able to weight bear following analgesia. On examination the patient is unsteady on her feet with difficulty maintaining an upright posture. Her husband reports over the last year she has started using a walking stick due to recurrent falls at home; prior to this she had never had any walking difficulties. She has increased tone in her upper limbs with a tremor more pronounced on the left side. Systems examination is otherwise unremarkable and she is GCS 15/15. She takes amlodipine for high blood pressure and paracetamol for osteoarthritis. What is the most likely underlying diagnosis?

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