Differential diagnosis | Investigation(s) |
Cervical/lumbar spondylosis | MRI spine |
Neoplasm; primary or secondary | MRI brain, spine |
Arnold Chiari malformation | MRI brain, spine |
Diplegic cerebral palsy | MRI brain, birth history |
Spinal cord arteriovenous malformation | MRI/spinal angiography |
Progressive multiple sclerosis | MRI, CSF analysis, evoked responses |
Motor neuron disease | EMG |
Spinocerebellar ataxias | Gene analysis |
ALD, AMN | MRI brain, VLCFA |
MLD | MRI brain, arylsulphatase |
Krabbe leukodystrophy | MRI, galactocerebrosidase |
Subacute combined degeneration of the cord | Vitamin B12 |
Arginase deficiency | Plasma arginine, aminoaciduria |
Neurolathyrism | History ofLathyrus sativus |
Abetalipoproteinemia | Lipoprotein electrophoresis |
Dopa responsive dystonia | L-dopa trial, gene analysis |
Vitamin E deficiency | Serum vitamin E level |
Neurosyphilis | Syphilis serology |
HTLV-1 infection (tropical spastic paraparesis) | Serum/CSF HTLV-1 antibodies |
AIDS | HIV testing, CD4 count |
ALD=adrenoleukodystrophy; AMD=adrenomyeloneuropathy; VLCFA=very long chain fatty acids; MLD=metachromatic leucodystrophy; HTLV-1=human T lymphotropic virus type1; AIDS=acquired immune deficiency syndrome; HIV=human immunodeficiency virus.