Clinical Reasoning: A 55-Year-Old Woman With a Hyperkinetic Movement Disorder, External Ophthalmoplegia, and Myopathy

Evaluating patients with multiple movement disorders can be challenging, especially in the setting of systemic involvement. We present a 55-year-old woman with an 8-year history of hyperkinetic movements, mild ataxia, lower limb spasticity, external ophthalmoplegia, and myopathy. This publication highlights the diagnostic approach to patients with complex neurologic presentations and walks readers through the creation of a comprehensive differential diagnosis.