A 62 years old man presents with a 6-month history of generalized fatigue and weakness. He initially noted difficulty ascending stairs and walking prolonged distances. Over the past several months, he has also developed intermittent dysarthria, difficulty raising his arms above his head, and impotence. On examination, prominent weakness in the pelvic and shoulder girdles with mild distal leg weakness is noted. Reflexes are initially absent, although they are obtainable after a brief period of exercise. Sensation and coordination are normal. What are the most important differential diagnoses?

Of the relevant differential diagnoses, it is important to rule out myasthenia gravis, Guillain-Barre syndrome and botulism.

Categorised in:

This post was written by Omar Rifai