Differential Diagnosis
The patient's symptoms of psychomotor slowing, slow speech, and lagging in extraocular movements with direct gaze suggest a range of potential diagnoses. Here is a categorized differential diagnosis:
- Single most likely diagnosis
- Parkinson's Disease: This condition is characterized by psychomotor slowing (bradykinesia), slow speech, and impaired extraocular movements, making it a strong candidate for the patient's symptoms.
- Other Likely diagnoses
- Hypothyroidism: This condition can cause slowing of physical and mental processes, including speech and movement, which aligns with the patient's symptoms.
- Depression: Severe depression can manifest with psychomotor retardation, including slow speech and movement, which may be considered in the differential diagnosis.
- Medication-induced parkinsonism: Certain medications, such as antipsychotics, can cause parkinsonian symptoms, including bradykinesia and slow speech.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Creutzfeldt-Jakob Disease: This rare, degenerative brain disorder can cause rapid decline in cognitive and motor function, including psychomotor slowing and impaired extraocular movements.
- Wilson's Disease: This genetic disorder can cause neurological symptoms, including parkinsonian features, and is important to consider due to its potential for severe consequences if left untreated.
- Rare diagnoses
- Progressive Supranuclear Palsy (PSP): This rare neurodegenerative disorder can cause impaired extraocular movements, particularly in the vertical plane, and may also present with psychomotor slowing and slow speech.
- Corticobasal Degeneration: This rare condition can cause a combination of motor and cognitive symptoms, including bradykinesia, slow speech, and impaired extraocular movements.