Differential Diagnosis for Unilateral Stocking Distribution Numbness

Single Most Likely Diagnosis

• Peripheral neuropathy: This is the most common cause of unilateral numbness in a stocking distribution, often due to diabetes, trauma, or compression.

Other Likely Diagnoses

• Lumbar radiculopathy: Nerve root compression or irritation in the lumbar spine can cause numbness in a stocking distribution on one side.
• Peripheral nerve compression: Compression of nerves such as the peroneal or tibial nerve can cause numbness in specific areas of the leg.
• Vitamin deficiencies: Deficiencies in vitamins like B12 can cause neuropathy, leading to numbness in the legs.

Do Not Miss Diagnoses

• Stroke or transient ischemic attack (TIA): Although less common, a stroke or TIA can cause unilateral numbness, and missing this diagnosis could be catastrophic.
• Spinal cord compression: Compression of the spinal cord, such as from a tumor or abscess, can cause numbness and is a medical emergency.
• Multiple sclerosis: This autoimmune disease can cause numbness and other neurological symptoms, and early diagnosis is crucial for treatment.

Rare Diagnoses

• Vasculitis: Inflammation of blood vessels can cause neuropathy and numbness, but this is a rare cause of unilateral stocking distribution numbness.
• Inherited neuropathies: Certain genetic conditions, such as Charcot-Marie-Tooth disease, can cause neuropathy and numbness, but these are relatively rare.
• Toxin exposure: Exposure to certain toxins, such as heavy metals, can cause neuropathy, but this is an uncommon cause of unilateral numbness.