Differential Diagnosis for Paresthesia in Bilateral Lower Extremities
Single Most Likely Diagnosis
- Diabetic Neuropathy: This is a common cause of paresthesia in the lower extremities, especially in patients with a history of diabetes. The high blood sugar levels damage the nerves, leading to symptoms such as numbness, tingling, and pain.
Other Likely Diagnoses
- Vitamin B12 Deficiency: A deficiency in vitamin B12 can cause damage to the nerves, leading to paresthesia in the lower extremities. This is often seen in patients with a history of malabsorption or a strict vegan diet.
- Peripheral Artery Disease (PAD): PAD can cause reduced blood flow to the lower extremities, leading to paresthesia, pain, and weakness.
- Hypothyroidism: Hypothyroidism can cause nerve damage and paresthesia in the lower extremities, as well as other symptoms such as fatigue and weight gain.
- Chronic Kidney Disease: Chronic kidney disease can cause nerve damage and paresthesia in the lower extremities, as well as other symptoms such as fatigue and swelling.
Do Not Miss Diagnoses
- Spinal Cord Compression: Spinal cord compression can cause paresthesia in the lower extremities, as well as weakness, bowel and bladder dysfunction, and loss of reflexes. This is a medical emergency that requires prompt attention.
- Guillain-Barré Syndrome: This is a rare autoimmune disorder that can cause rapid onset of paresthesia, weakness, and paralysis in the lower extremities. It can be life-threatening if not treated promptly.
- Multiple Sclerosis: Multiple sclerosis can cause paresthesia in the lower extremities, as well as other symptoms such as vision loss, weakness, and balance problems.
- Cauda Equina Syndrome: This is a rare condition that occurs when the nerves in the lower spine are compressed, causing paresthesia, weakness, and bowel and bladder dysfunction.
Rare Diagnoses
- Amyloidosis: This is a rare condition that can cause nerve damage and paresthesia in the lower extremities, as well as other symptoms such as weight loss and fatigue.
- Sarcoidosis: This is a rare condition that can cause nerve damage and paresthesia in the lower extremities, as well as other symptoms such as lung disease and skin lesions.
- Lyme Disease: This is a rare condition that can cause nerve damage and paresthesia in the lower extremities, as well as other symptoms such as fever, headache, and rash.
- Heavy Metal Poisoning: Exposure to heavy metals such as lead, mercury, or arsenic can cause nerve damage and paresthesia in the lower extremities.