Differentials
Parkinson disease
SIGNS / SYMPTOMS
Bradykinesia, rigidity, and resting tremor.
INVESTIGATIONS
Primarily a clinical diagnosis. Neuroimaging may be used for difficult cases.
Amyotrophic lateral sclerosis
SIGNS / SYMPTOMS
Muscle spasms, stiffness, unsteady gait, foot or head drop, posture difficulties, speech difficulties, dyspnea.
INVESTIGATIONS
Electromyography and nerve conduction studies show evidence of diffuse, ongoing, chronic denervation.
Myopathy
SIGNS / SYMPTOMS
Muscle aches and weaknesses caused by a large number of conditions, such as connective tissue diseases, and by certain drugs.
INVESTIGATIONS
Abnormal laboratory test results, such as elevated creatine kinase.
Immunologic investigations.
Cachexia
SIGNS / SYMPTOMS
Rapid loss of muscle and fat tissue in the presence of an underlying condition, such as some types of cancer or advanced heart failure.[53]
INVESTIGATIONS
Blood tests and imaging to find a malignancy.
Hyperthyroidism
SIGNS / SYMPTOMS
Heat intolerance, sweating, palpitations, tremor, diffuse goiter, orbitopathy.
INVESTIGATIONS
Blood tests for thyroid profile and antithyroid antibodies.
Hypothyroidism
SIGNS / SYMPTOMS
Vague, nonspecific symptoms, but may include lethargy, constipation, weight gain, and depression.
INVESTIGATIONS
Blood tests for thyroid profile and antithyroid antibodies.
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