Differential Diagnosis for Restlessness
The differential diagnosis for restlessness is broad and can be categorized into several groups based on the likelihood and potential impact of missing the diagnosis.
Single Most Likely Diagnosis
- Anxiety disorder: This is often the most common cause of restlessness, as anxiety can manifest physically and psychologically, leading to feelings of agitation and restlessness.
Other Likely Diagnoses
- Substance withdrawal (e.g., alcohol, benzodiazepines, opioids): Withdrawal from substances can cause significant restlessness and agitation.
- Sleep disorders (e.g., insomnia, restless leg syndrome): Disorders that affect sleep quality can lead to restlessness during the day.
- Hyperthyroidism: An overactive thyroid gland can cause increased nervousness, anxiety, and restlessness.
- Attention Deficit Hyperactivity Disorder (ADHD): Characterized by symptoms of inattention, hyperactivity, and impulsivity, which can include restlessness.
- Medication side effects: Certain medications, such as those used to treat depression or attention deficit hyperactivity disorder, can cause restlessness as a side effect.
Do Not Miss Diagnoses
- Akathisia: A movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion, often associated with the use of antipsychotic medications.
- Serotonin syndrome: A potentially life-threatening medical condition resulting from an excess of serotonin in the body, which can cause agitation, confusion, and restlessness.
- Neuroleptic malignant syndrome: A rare but life-threatening side effect of neuroleptic or antipsychotic medication, characterized by fever, muscle stiffness, and altered mental status, which can include restlessness.
- Hypoglycemia: Low blood sugar can cause restlessness, confusion, and agitation, and is a medical emergency if not promptly treated.
Rare Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of hypertension, tachycardia, sweating, and restlessness.
- Wilson's disease: A genetic disorder that leads to copper accumulation in the body, which can cause neurological symptoms including restlessness.
- Huntington's disease: A progressive brain disorder that causes certain nerve cells in the brain to waste away, leading to cognitive, motor, and psychiatric problems, including restlessness.
- Creutzfeldt-Jakob disease: A rare, degenerative, fatal brain disorder that can cause a variety of neurological symptoms, including restlessness and agitation.