Social history should note the following: Use of alcohol: Suggesting alcoholic myopathy Illicit drug use: Suggesting increased risk of HIV / AIDS, bacterial infections, tuberculosis, or stroke due to cocaine use Occupational or other exposure to toxins (eg, organophosphate insecticides, heavy metals, industrial solvents) Recent travel: Suggesting Lyme disease, tick paralysis, diphtheria, or a parasitic infection Social stressors: Suggesting depression Physical examination A complete neurologic and muscle examination is done to identify localizing or diagnostic findings.