Differential Diagnosis for Body Paresthesias

Single Most Likely Diagnosis

• Vitamin B12 Deficiency: This condition is a common cause of body paresthesias, particularly in the hands and feet, due to its role in the synthesis of myelin, the fatty substance that surrounds and protects nerve fibers.

Other Likely Diagnoses

• Diabetes Mellitus: High blood sugar levels can damage nerves, leading to paresthesias, especially in a stocking-glove distribution.
• Hypothyroidism: This condition can cause paresthesias due to the metabolic effects on nerve function and the potential for associated vitamin deficiencies.
• Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including paresthesias.
• Peripheral Neuropathy: Damage to the peripheral nerves can cause paresthesias, and this can be due to various factors including diabetes, alcohol abuse, or certain medications.

Do Not Miss Diagnoses

• Spinal Cord Compression: A serious condition that requires immediate medical attention, as it can lead to permanent neurological damage if not promptly treated.
• Stroke or Transient Ischemic Attack (TIA): Although less common, paresthesias can be a presenting symptom of a stroke or TIA, especially if accompanied by other neurological deficits.
• Guillain-Barré Syndrome: A rare autoimmune disorder in which the body's immune system mistakenly attacks part of its peripheral nervous system, which can lead to life-threatening paralysis.
• Lyme Disease: Caused by the bacterium Borrelia burgdorferi, transmitted to humans through the bite of infected black-legged ticks, can cause neurological symptoms including paresthesias.

Rare Diagnoses

• Sjögren's Syndrome: An autoimmune disorder that can cause nerve damage leading to paresthesias, among other symptoms.
• Sarcoidosis: A condition in which inflammatory cells form lumps known as granulomas in various parts of the body, including the nervous system, leading to paresthesias.
• Tangier Disease: A rare inherited disorder characterized by significantly low levels of high-density lipoprotein (HDL) cholesterol, which can lead to peripheral neuropathy and paresthesias.
• Fabry Disease: A genetic 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 causing paresthesias.