What is the diagnosis for a patient presenting with distal myopathy and unilateral foot drop (peroneal neuropathy)?

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Differential Diagnosis for Distal Myopathy with Unilateral Foot Drop

  • Single most likely diagnosis
    • Charcot-Marie-Tooth disease: A group of inherited disorders that affect the peripheral nerves, leading to distal muscle weakness and atrophy, which can present with unilateral foot drop.
  • Other Likely diagnoses
    • Peripheral neuropathy: Conditions such as diabetic neuropathy or neuropathy due to other causes (e.g., vitamin deficiencies) can lead to distal weakness and foot drop.
    • L5 radiculopathy: Compression or damage to the L5 nerve root can cause weakness and foot drop, typically on one side.
    • Distal myopathies (e.g., Welander, Miyoshi, and Udd distal myopathies): A group of inherited myopathies that primarily affect the distal muscles, which can present with unilateral foot drop.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Neoplastic or malignant peripheral nerve sheath tumors: Although rare, these tumors can compress or infiltrate nerves, leading to unilateral foot drop and other neurological symptoms.
    • Vasculitic neuropathy (e.g., due to giant cell arteritis or polyarteritis nodosa): Inflammatory conditions that can cause nerve damage and foot drop, which require prompt treatment to prevent further complications.
  • Rare diagnoses
    • Inclusion body myositis: A rare inflammatory myopathy that can present with distal weakness and foot drop, although it typically affects both sides.
    • Focal muscular dystrophy: A rare condition characterized by localized muscle weakness and atrophy, which can present with unilateral foot drop.
    • Toxic or drug-induced neuropathy: Certain toxins or medications can cause peripheral neuropathy, leading to distal weakness and foot drop.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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