Differential Diagnosis for 75 YOM with Hyperparasthesia

• Single most likely diagnosis
  • Restless Legs Syndrome (RLS): Characterized by an irresistible urge to move the legs, usually due to uncomfortable sensations such as tingling, burning, or itching. Symptoms are typically worse at night and relieved by movement, which matches the patient's presentation.
• Other Likely diagnoses
  • Peripheral Neuropathy: Could be due to various causes such as vitamin deficiencies (e.g., B12), but the absence of diabetes (a common cause) makes it less likely. However, it's still a consideration given the patient's age and symptoms of hyperparasthesia.
  • Small Fiber Neuropathy: Often presents with burning pain and hyperparasthesia, primarily in the feet. It can be idiopathic or associated with various conditions.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Vitamin B12 Deficiency: A deficiency can cause neurological symptoms including neuropathy, which could present similarly to the patient's symptoms. It's crucial to diagnose and treat to prevent irreversible neurological damage.
  • Heavy Metal Poisoning (e.g., Lead, Arsenic): Though less common, exposure to heavy metals can cause neuropathy and other neurological symptoms. Given the potential severity, it's essential to consider and rule out.
• Rare diagnoses
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. It could be considered if other diagnoses are ruled out, though it's less likely given the specific symptoms described.
  • Complex Regional Pain Syndrome (CRPS): Typically follows an injury and is characterized by intense burning or aching pain in the hands or feet. It's a less likely diagnosis given the bilateral and symmetric nature of the patient's symptoms without a reported inciting event.