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Differential Diagnosis for Restless Legs at Night

Single Most Likely Diagnosis

  • Restless Legs Syndrome (RLS): Characterized by an irresistible urge to move the legs, usually due to uncomfortable sensations such as itching, burning, or tingling. Symptoms worsen at night and are relieved by movement.

Other Likely Diagnoses

  • Iron Deficiency: Often associated with RLS symptoms, iron deficiency can exacerbate or trigger restless legs syndrome.
  • Peripheral Neuropathy: Conditions like diabetes can cause peripheral neuropathy, leading to symptoms similar to RLS, including pain, numbness, and tingling in the legs.
  • Chronic Kidney Disease: Patients with chronic kidney disease may experience RLS symptoms due to electrolyte imbalances and uremia.
  • Medication-Induced: Certain medications, such as antidepressants, antihistamines, and antipsychotics, can cause or worsen RLS symptoms.

Do Not Miss Diagnoses

  • Diabetic Neuropathy: A serious complication of diabetes that can cause severe pain, numbness, and weakness in the legs, which might be mistaken for RLS.
  • Peripheral Artery Disease (PAD): While less common, PAD can cause leg pain at night, especially when lying down, which might be confused with RLS.
  • Neurodegenerative Diseases (e.g., Parkinson’s Disease): Some neurodegenerative diseases can present with symptoms similar to RLS, and missing these diagnoses could have significant implications for patient management and prognosis.

Rare Diagnoses

  • Akathisia: A movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion, which can be mistaken for RLS.
  • Plexopathy or Radiculopathy: Inflammation or damage to the nerves in the legs can cause symptoms similar to RLS, including pain and weakness.
  • Vitamin B12 Deficiency: Similar to iron deficiency, a lack of vitamin B12 can lead to neurological symptoms, including those that mimic RLS.

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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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