Differential Diagnosis for Numbness and Tingling in Bilateral Legs and Feet
Single Most Likely Diagnosis
- Peripheral Neuropathy: Given the patient's age and history of hypertension, peripheral neuropathy is a common condition that can cause numbness and tingling in the legs and feet. The symptoms have been present for a week, which is consistent with the gradual onset of peripheral neuropathy.
Other Likely Diagnoses
- Vitamin B12 Deficiency: A deficiency in vitamin B12 can cause numbness and tingling in the extremities, and it is a relatively common condition in older adults.
- Diabetic Neuropathy: Although the patient's history does not mention diabetes, it is possible that they have undiagnosed diabetes, which can cause peripheral neuropathy.
- Spinal Stenosis: This condition can cause numbness and tingling in the legs and feet, especially if the patient has a history of back problems or degenerative disc disease.
Do Not Miss Diagnoses
- Spinal Cord Infarction: Although less likely, a spinal cord infarction can cause sudden onset of numbness and tingling in the legs and feet, and it is a medical emergency that requires prompt attention.
- Cauda Equina Syndrome: This is a rare but serious condition that can cause numbness and tingling in the legs and feet, as well as bowel and bladder dysfunction.
- Multiple Sclerosis: Although less common, multiple sclerosis can cause numbness and tingling in the extremities, and it is essential to consider this diagnosis to avoid missing a potentially treatable condition.
Rare Diagnoses
- Heavy Metal Poisoning: Exposure to heavy metals such as lead or mercury can cause peripheral neuropathy, but this is a rare condition.
- Amyloidosis: This is a rare condition that can cause peripheral neuropathy, but it is usually associated with other systemic symptoms.
- Vasculitis: Inflammation of the blood vessels can cause peripheral neuropathy, but this is a rare condition that is usually associated with other systemic symptoms.