Differential Diagnosis for a 16-year-old girl with dyskinesia in the left lower limb since 2 days
- The following differential diagnoses are organized into categories based on their likelihood and potential impact on the patient's health.
Single most likely diagnosis
- Conversion disorder: This condition is characterized by the presence of neurological symptoms, such as dyskinesia, that cannot be explained by a medical condition. It is often associated with psychological stress or trauma, and the sudden onset of symptoms in a 16-year-old girl, who is in a stage of significant psychological and social change, makes this diagnosis a strong consideration.
Other Likely diagnoses
- Tics or Tourette's syndrome: Although tics are more common in children, they can persist into adolescence. The sudden onset of dyskinesia in one limb could be a tic, especially if the patient has a history of similar symptoms.
- Focal dystonia: This condition involves involuntary muscle contractions, which could cause dyskinesia. It can be primary (idiopathic) or secondary to another condition, and its onset can be sudden.
- Chorea: This is a neurological disorder characterized by involuntary, unpredictable movements. It can be caused by various conditions, including autoimmune disorders, infections, or genetic conditions.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Stroke or cerebral vasculitis: Although rare in adolescents, a stroke or cerebral vasculitis could cause sudden-onset dyskinesia. It is crucial to rule out these conditions, as they require immediate medical attention.
- Intracranial tumor or cyst: A brain tumor or cyst could cause focal neurological symptoms, including dyskinesia. Although less common, this possibility should not be overlooked.
- Infections (e.g., meningitis, encephalomeningitis): Certain infections can cause sudden-onset neurological symptoms, including dyskinesia. It is essential to consider and rule out these conditions, as they require prompt treatment.
Rare diagnoses
- Wilson's disease: This is a rare genetic disorder that can cause neurological symptoms, including dyskinesia, due to copper accumulation in the brain. Although rare, it should be considered in the differential diagnosis, especially if other symptoms are present.
- Huntington's disease: This is an autosomal dominant genetic disorder that can cause chorea and other neurological symptoms. Although it typically presents in adulthood, juvenile-onset cases can occur.
- Syphilis: This infection can cause a range of neurological symptoms, including dyskinesia, in its tertiary stage. Although rare, it should be considered in the differential diagnosis, especially if other risk factors are present.