Differential Diagnosis for Tingling of Mouth and Hands and Feet on Both Sides

Single Most Likely Diagnosis

• Hypocalcemia: This condition, characterized by low calcium levels in the blood, can cause tingling sensations in the mouth, hands, and feet due to its effect on nerve function. The symptoms can be bilateral and are a common presentation of hypocalcemia.

Other Likely Diagnoses

• Hyperventilation Syndrome: This condition can lead to respiratory alkalosis, which in turn can cause tingling sensations in the hands and feet, as well as around the mouth. It's often associated with anxiety attacks.
• Vitamin B12 Deficiency: A deficiency in vitamin B12 can cause neurological symptoms, including tingling in the hands and feet. While less common, it could also affect the mouth.
• Diabetes Mellitus: Early stages of diabetes can cause neuropathy, leading to tingling sensations in the extremities. Though less commonly associated with mouth tingling, it's a consideration given the widespread nature of diabetes.

Do Not Miss Diagnoses

• Multiple Sclerosis: Although less likely, multiple sclerosis (MS) is a critical diagnosis not to miss. MS can cause a wide range of neurological symptoms, including tingling sensations in various parts of the body, due to demyelination of nerve fibers.
• Guillain-Barré Syndrome: This is an autoimmune disorder that can cause rapid-onset muscle weakness and tingling sensations, often starting in the feet and hands and potentially affecting the face and mouth. It's a medical emergency due to the risk of respiratory failure.
• Heavy Metal Poisoning (e.g., Lead, Mercury): Exposure to certain heavy metals can cause neurological symptoms, including tingling in the hands and feet. These conditions are critical to identify due to their potential for severe and long-lasting health effects.

Rare Diagnoses

• Sarcoidosis: A condition characterized by the growth of granulomas in various parts of the body, which can rarely cause neurological symptoms including tingling if it affects the nerves.
• Peripheral Artery Disease: While more commonly associated with pain in the legs during walking, in rare cases, it could cause tingling sensations in the feet and, less commonly, the hands, especially if there's significant vascular disease.
• Amyloidosis: A group of diseases that result from the abnormal accumulation of amyloid proteins in various tissues, which can rarely cause neuropathy leading to tingling sensations.