Differential Diagnosis for Bilateral Hand Numbness
Single Most Likely Diagnosis
- Thoracic Outlet Syndrome (TOS): This condition is characterized by compression of the bracchial plexus or subclavian vessels, which can cause numbness, tingling, and weakness in the hands. The symptoms worsen with arm elevation, making it a likely diagnosis given the patient's symptoms.
Other Likely Diagnoses
- Cervical Spondylosis: This condition involves wear and tear on the cervical spine, which can compress nerves and cause numbness, tingling, and weakness in the hands. The symptoms can worsen with certain positions, such as arm elevation.
- Carpal Tunnel Syndrome: Although this condition typically affects one hand, it can be bilateral. The numbness is usually limited to the thumb, index, and middle fingers, but some patients may experience numbness in all fingers.
- Peripheral Neuropathy: This condition can cause numbness, tingling, and weakness in the hands, especially in patients with underlying medical conditions such as diabetes.
Do Not Miss Diagnoses
- Cervical Spinal Cord Compression: This is a potentially life-threatening condition that requires prompt diagnosis and treatment. Compression of the cervical spinal cord can cause numbness, tingling, and weakness in the hands, as well as other symptoms such as loss of bladder control.
- Vascular Occlusion: Occlusion of the subclavian or brachial arteries can cause numbness, tingling, and weakness in the hands, especially with arm elevation.
Rare Diagnoses
- Guillain-Barré Syndrome: This is a rare autoimmune disorder that can cause numbness, tingling, and weakness in the hands, as well as other symptoms such as muscle weakness and paralysis.
- Syringomyardia: This is a rare condition characterized by a fluid-filled cavity within the spinal cord, which can cause numbness, tingling, and weakness in the hands.
- Tumor or Mass Lesion: A tumor or mass lesion in the thoracic outlet or cervical spine can compress nerves and cause numbness, tingling, and weakness in the hands.