Which condition is least likely to present with sudden weakness as a symptom?

Sudden weakness is a common symptom associated with both strokes and transient ischemic attacks (TIAs), which are both conditions that affect blood flow to the brain. In a stroke, the disruption of blood flow to a part of the brain can result in sudden onset of weakness or paralysis, typically on one side of the body. Similarly, a TIA produces similar symptoms but these tend to be temporary, often resolving within minutes to hours.

Multiple Sclerosis (MS) can also result in weakness; however, it is typically characterized by varying symptoms that can develop more gradually, including episodes of weakness that may come and go along with other neurological symptoms. The nature of MS symptoms is often chronic and relapsing rather than suddenly occurring.

Myocardial Infarction primarily presents with chest pain or discomfort, among other symptoms such as shortness of breath, sweating, nausea, and in some cases, weakness or lightheadedness. However, sudden weakness is not the hallmark presentation of a heart attack. This distinguishes it from the other conditions listed, where sudden weakness is a more defining symptom. Thus, myocardial infarction is the condition least likely to present primarily with sudden weakness.