Case Presentation: An 87-year-old woman with a history of pancreatic cancer status post distal pancreatectomy/splenectomy/partial colectomy, chronic kidney disease, hepatocellular carcinoma, and diabetes was admitted following sudden onset of new, uncontrollable bilateral upper extremity shaking and facial twitching. Symptoms started the night before and became progressively worse with dyspnea, nausea, and bilateral lower extremity tremors [...]