Differential Diagnosis for Acute Leg Weakness in the Setting of Alcoholism
- Single most likely diagnosis
- Wernicke's encephalopathy: This condition is a common complication of alcoholism, characterized by acute onset of confusion, ataxia, and ophthalmoplegia. Leg weakness can be a presenting symptom, and prompt treatment with thiamine is essential to prevent long-term damage.
- Other Likely diagnoses
- Alcoholic myopathy: Chronic alcohol consumption can lead to muscle weakness, including leg weakness, due to muscle damage and nutritional deficiencies.
- Peripheral neuropathy: Alcoholism is a common cause of peripheral neuropathy, which can present with leg weakness, numbness, and tingling.
- Rhabdomyolysis: Alcoholism can increase the risk of rhabdomyolysis, a condition characterized by muscle breakdown, which can cause leg weakness and other symptoms.
- Do Not Miss diagnoses
- Guillain-Barré syndrome: This rare autoimmune disorder can cause rapid onset of leg weakness and paralysis, and prompt treatment is essential to prevent long-term damage.
- Spinal cord compression: Alcoholism can increase the risk of trauma and other conditions that can cause spinal cord compression, leading to leg weakness and other symptoms.
- Thiamine deficiency-induced lactic acidosis: Thiamine deficiency is common in alcoholism, and can cause lactic acidosis, which can present with leg weakness and other symptoms.
- Rare diagnoses
- Lead poisoning: Alcoholism can increase the risk of lead poisoning, which can cause leg weakness and other symptoms.
- Porphyria: This rare genetic disorder can cause acute onset of leg weakness, abdominal pain, and other symptoms, and is sometimes associated with alcoholism.
- Vasculitis: Certain types of vasculitis, such as polyarteritis nodosa, can cause leg weakness and other symptoms, and are sometimes associated with alcoholism.