Differential Diagnosis
- Single most likely diagnosis
- Anxiety or panic attack aftermath: The symptoms described, such as feeling shaky, tired, and a tickle sensation, are common after a significant anxiety or panic event. The body's stress response, often referred to as "fight or flight," can leave a person feeling drained and experiencing residual physical sensations after the initial event has passed.
- Other Likely diagnoses
- Hyperventilation syndrome: This condition, often associated with anxiety, can lead to feelings of shakiness, fatigue, and unusual sensations such as tingling or tickling due to altered breathing patterns affecting carbon dioxide levels in the blood.
- Sleep disturbance: Stress and anxiety can disrupt sleep patterns, leading to fatigue and possibly unusual sensations due to poor sleep quality or duration.
- Medication side effects: If the individual is on any medications, especially those for anxiety or other psychiatric conditions, side effects could include feelings of shakiness, fatigue, and unusual sensations.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Thyroid storm: Although less common, a thyroid storm can present with anxiety, tremors, and fatigue. It's a life-threatening condition that requires immediate medical attention.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of anxiety, tremors, and fatigue due to excessive catecholamine release.
- Hypoglycemia: Low blood sugar can cause shakiness, fatigue, and tingling sensations, especially in individuals with diabetes or those who have not eaten for a while.
- Rare diagnoses
- Multiple sclerosis: Certain types of multiple sclerosis can present with unusual sensations such as tingling or tickling, though this would typically be accompanied by other neurological symptoms.
- Peripheral neuropathy: Damage to the peripheral nerves can cause a variety of sensations including tingling, but this is usually more localized and accompanied by other symptoms such as numbness or weakness.
- Vitamin deficiencies (e.g., B12 deficiency): Certain vitamin deficiencies can cause neurological symptoms including fatigue and unusual sensations, but these would typically develop over a longer period and be accompanied by other signs of deficiency.