68-year-old male with history of hypertension, chronic kidney disease presenting from home with wife at bedside for confusion and shaking movements. Per wife, the patient is independent at baseline. He walks, drives and still works. Yesterday, he complained of a mild headache and this morning she noticed he seemed more confused, described as asking repetitive questions and wandering around the house. Prior to coming into the emergency department, the patient had a one-minute episode of full body shaking. This has never happened before. He has no history of seizure activity. The shaking resolved on its own and the patient was very tired afterwards while awaiting the ambulance. ..

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