Assessment of paraesthesias

Last reviewed: 4 Jun 2022
Last updated: 04 May 2022

Summary

Differentials

Common

  • Carpal tunnel syndrome
  • Ulnar neuropathy at elbow (UNE)
  • Fibular (peroneal) neuropathy
  • Meralgia paraesthetica
  • Cervical radiculopathy
  • Thoracic radiculopathy
  • Lumbosacral radiculopathy
  • Spinal cord compression
  • Multiple sclerosis
  • Distal symmetric polyneuropathy (DSP)
  • Diabetes mellitus
  • Hypothyroidism
  • Vitamin B1 deficiency
  • Vitamin B6 deficiency or excess
  • Vitamin B12 deficiency
  • Vitamin E deficiency
  • Drug toxicity
  • Alcoholic neuropathy
  • Stroke/transient ischaemic attack
  • Migraine with aura
  • Peripheral vascular disease
  • Panic attack with hyperventilation
  • Charcot-Marie-Tooth disease
  • Hereditary sensory and autonomic neuropathy (HSAN)
  • Hereditary neuropathy with liability to pressure palsy (HNPP)
Full details

Uncommon

  • Brachial plexopathy
  • Lumbosacral plexopathy
  • Tibial neuropathy
  • Trigeminal neuropathy
  • Acute demyelinating encephalomyelitis
  • Acute inflammatory demyelinating polyneuropathy (AIDP)
  • Chronic inflammatory demyelinating polyneuropathy (CIDP)
  • Chronic inflammatory demyelinating sensory polyradiculopathy (CISP)
  • Uraemia
  • Hypocalcaemia
  • Copper deficiency
  • Heavy metal poisoning
  • Radiation
  • Hexane
  • Ciguatera or saxitoxin poisoning
  • HIV neuropathy
  • Leprosy
  • Herpes simplex infection
  • Neurosyphilis
  • Herpes zoster infection (shingles)
  • Lyme disease
  • Conversion and somatic symptom disorders
  • Inborn errors of metabolism
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Churg-Strauss syndrome
  • Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis)
  • Polyarteritis nodosa
  • Microscopic polyangiitis
  • Sjogren's syndrome
  • Sarcoidosis
  • Monoclonal protein production
  • Focal seizures
  • Paraneoplastic sensory neuropathy or ganglionopathy
  • Intravascular lymphoma
  • Neuro-Behcet's disease
  • Wartenberg's migrant sensory neuritis
  • Numb chin syndrome
  • Peripheral neuropathy after bariatric surgery
  • Notalgia paraesthetica
  • Neuromyelitis optica spectrum disorder (Devic's disease)
  • Anti-myelin-associated glycoproteins (MAG) peripheral neuropathy
  • Hypertriglyceridaemia
  • Human T-lymphotropic virus (HTLV)
Full details

Contributors

Authors

Nigel Ashworth, MBChB, MSc, FRCP(Can)

Professor

Division of Physical Medicine & Rehabilitation

Faculty of Medicine & Dentistry

University of Alberta

Edmonton

Canada

Disclosures

NA declares that he has no competing interests.

Acknowledgements

Dr Nigel Ashworth would like to gratefully acknowledge the late Dr Caroline M. Klein for her contribution to this topic.

Disclosures

CMK authored a number of references cited in this topic.

Peer reviewers

Annabel Wang, MD

Director

Neuromuscular Diagnostic Laboratory

Associate Professor

Department of Neurology

ALS and Neuromuscular Center

University of California

Irvine

CA

Disclosures

AW declares that she has no competing interests.

Richard W. Orrell, BSc, MD, FRCP

Senior Lecturer and Consultant Neurologist

Department of Clinical Neuroscience

UCL Institute of Neurology

London

UK

Disclosures

RWO declares that he has no competing interests.

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