SPASTIC PARAPARESIS_HYPERTHYROIDISM A MIMICKER OF MOTOR NEURON DISEASE?
A 50 year old female patient, agricultural labourer by occupation presented to the General Medicine OPD with the complaints of weakness of lower limbs, insidious in onset, gradually progressive type since 2 years. She was apparently asymptomatic 2 years back then she developed proximal muscle weakness in the lower limbs ,initially in the right lower limb followed by left lower limb. She had difficulty in getting up from sitting posture. Sh doesnt give any history of loss of consciousness, seizures, giddiness, bowel/bladder incontinence,cranial nerve anbormalities,paresthesias in the limbs. H/o Weight loss present. Past history : Not a k/c/o Hypertension,Diabetes mellitus,Thyroid disorders,pulmonary kochs,epilepsy,asthma. Family history : No history of similar complaints in the family. Not a k/c/o Hypertension,Diabetes mellitus,Thyroid disorders,pulmonary kochs,epilepsy,asthma. Personal history: Mixed diet Appetite adequate. Bowel and bladder regular No sleep di