I am a physical therapist working in a skilled nursing facility. Today I saw a resident of the facility who was referred to PT due to weakness that had gotten worse in the last week. She had (B) UE swelling, diffuse and throughout her fingers, significant inability to grip or hold objects in both arms, and her pupils were very constricted. She also had what appeared to be tremors in her jaw. I expressed my concerns to the nursing staff, who called her physician. She was sent out via ambulance to the ER late this pm. I am curious as to what this strange collection of symptoms might be.