Differential Diagnosis for Paresthesia in Inner Legs with Urinary Urgency
Single Most Likely Diagnosis
- Multiple Sclerosis (MS): A chronic autoimmune disease that affects the central nervous system, leading to demyelination and a wide range of neurological symptoms. Paresthesia in the inner legs and urinary urgency are common presenting symptoms of MS, especially in the relapsing-remitting form.
Other Likely Diagnoses
- Lumbar Disc Herniation: Although the patient denies back pain, a herniated disc can cause nerve root compression leading to paresthesia in the inner legs. Urinary urgency can also occur if the compression affects the nerves controlling bladder function.
- Peripheral Neuropathy: Conditions such as diabetes, vitamin deficiencies, or alcohol abuse can cause peripheral neuropathy, leading to paresthesia in the legs. Autonomic dysfunction can also result in urinary urgency.
- Cauda Equina Syndrome (CES) without Back Pain: A condition where the nerves in the spinal canal are compressed, leading to neurological symptoms. Some patients may not experience back pain, but paresthesia in the inner legs and urinary urgency are common symptoms.
Do Not Miss Diagnoses
- Spinal Cord Compression: A serious condition that requires immediate attention, spinal cord compression can cause paresthesia, urinary urgency, and other neurological symptoms. It can be due to various causes, including tumors, abscesses, or hematoma.
- Guillain-Barré Syndrome: An autoimmune disorder that can cause rapid onset of muscle weakness, paresthesia, and autonomic dysfunction, including urinary urgency.
- Tabes Dorsalis: A late manifestation of syphilis, characterized by demyelination of the dorsal columns and roots, leading to paresthesia, urinary urgency, and other neurological symptoms.
Rare Diagnoses
- Sjögren's Syndrome: An autoimmune disorder that can cause peripheral neuropathy, leading to paresthesia in the legs, as well as autonomic dysfunction resulting in urinary urgency.
- Vitamin B12 Deficiency: A condition that can cause subacute combined degeneration of the spinal cord, leading to paresthesia, urinary urgency, and other neurological symptoms.
- Amyloidosis: A group of diseases characterized by the deposition of amyloid proteins in various tissues, including the nerves, leading to peripheral neuropathy and autonomic dysfunction.