Differential Diagnosis for Electric Shock and Pinching Sensation in Hands and Legs

Single Most Likely Diagnosis

• Peripheral Neuropathy: This condition is characterized by damage to the peripheral nerves, often causing symptoms such as electric shock sensations, pinching, and numbness in the hands and legs. It can be due to various factors including diabetes, vitamin deficiencies, or alcohol abuse.

Other Likely Diagnoses

• Multiple Sclerosis: An autoimmune disease affecting the central nervous system, which can cause a wide range of neurological symptoms including electric shock-like sensations, known as Lhermitte's sign, particularly when the neck is flexed.
• Vitamin B12 Deficiency: A deficiency in vitamin B12 can lead to neurological symptoms including numbness, tingling, and electric shock-like sensations in the hands and legs.
• Hypocalcemia: Low calcium levels can cause muscle cramps, spasms, and tingling or electric shock sensations in the extremities.
• Carpal Tunnel Syndrome and Peripheral Nerve Entrapments: Conditions where nerves are compressed, leading to symptoms like numbness, tingling, and electric shock sensations in specific areas, depending on the nerve affected.

Do Not Miss Diagnoses

• Guillain-Barré Syndrome: A rare but serious autoimmune disorder where the body's immune system mistakenly attacks part of its peripheral nervous system, which can lead to life-threatening paralysis. Early symptoms may include tingling or electric shock sensations in the hands and legs.
• Spinal Cord Compression: Compression of the spinal cord can cause a variety of symptoms including electric shock sensations, numbness, and weakness in the hands and legs, and requires urgent medical attention.
• Stroke or Transient Ischemic Attack (TIA): Although less common, sudden onset of neurological symptoms such as numbness, tingling, or electric shock sensations in the hands and legs could be indicative of a stroke or TIA, especially if accompanied by other symptoms like facial weakness or speech difficulties.

Rare Diagnoses

• Tangier Disease: A rare inherited disorder characterized by significantly low levels of high-density lipoprotein (HDL) cholesterol, which can lead to peripheral neuropathy and symptoms like electric shock sensations.
• Fabry Disease: An inherited disorder that results from the buildup of a particular type of fat in the body's cells, affecting many parts of the body including the nervous system, and can cause burning pain, numbness, or electric shock sensations in the hands and feet.
• Sjögren's Syndrome: An autoimmune disorder that can cause peripheral neuropathy, leading to symptoms such as electric shock sensations, among other systemic manifestations.