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A 75-year-old man went to hospital presenting as parkinsonian syndrome. After detailed history inquiry, physical examination, advanced test of thyroid function and associated antibodies, the final diagnosis is chronic thyrotoxic myopathy. The symptoms of the patient improved significantly after treating with methimazole. This patient had a long history and accepted treatments in many hospitals. He presented as parkinsonian syndrome, but after treatment as parkinson’s disease, his symptoms didn’t improve. After carefully physical examination, we detected signs of hyperthyroidism. This case suggested that myopathy caused by systemic diseases should be remembered in the differential diagnosis of patients presenting as parkinsonian syndrome.