Differential Diagnosis for RUE/RLE Weakness/Sensation Deficits
Single Most Likely Diagnosis
- Radial Neuropathy: This condition often presents with weakness and sensation deficits in the radial nerve distribution, affecting the right upper extremity (RUE) or right lower extremity (RLE), depending on the specific nerve involvement. It can result from compression, trauma, or other insults to the radial nerve.
Other Likely Diagnoses
- Peroneal Neuropathy: Affecting the common peroneal nerve, this condition can lead to foot drop and sensory loss on the lateral aspect of the leg and the dorsum of the foot, fitting with RLE weakness and sensation deficits.
- L5 or C6 Radiculopathy: These nerve root impingements can cause pain, weakness, and sensory disturbances in the distribution of the affected nerve root, potentially explaining RLE or RUE symptoms, respectively.
- Stroke or Transient Ischemic Attack (TIA): Although less specific, a stroke or TIA can present with sudden onset of weakness and sensory deficits, typically unilateral, which could involve either an upper or lower extremity.
Do Not Miss Diagnoses
- Spinal Cord Compression: Conditions like spinal stenosis, herniated discs, or tumors can compress the spinal cord, leading to bilateral or unilateral weakness and sensory deficits, depending on the level and extent of compression. Missing this diagnosis could result in permanent neurological damage.
- Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including weakness and sensory deficits in various distributions.
- Guillain-Barré Syndrome: An autoimmune disorder that can cause rapid-onset muscle weakness and sensory deficits, often ascending from the lower extremities. It is a medical emergency due to the risk of respiratory failure.
Rare Diagnoses
- Neurosyphilis: A condition resulting from late or tertiary syphilis infection, which can cause a variety of neurological symptoms, including weakness and sensory deficits, though it is less common in the modern era due to antibiotic treatments.
- Vasculitis (e.g., Giant Cell Arteritis, Polyarteritis Nodosa): Inflammatory diseases affecting blood vessels, which can lead to neurological symptoms by compromising blood flow to nerves or the spinal cord.
- Lyme Disease: Caused by the bacterium Borrelia burgdorferi, transmitted by ticks. Neurological manifestations can include radiculopathy, meningitis, and encephalitis, among others, though these are relatively rare compared to other symptoms like erythema migrans.