CLINICAL DIAGNOSTIC MANUAL
Diminished sensation in the leg, known as hypoesthesia, is a condition involving the reduction or loss of sensory capability in one or both legs. This can manifest as numbness, tingling, or a complete lack of sensitivity.
The causes may range from peripheral neuropathies, affecting sensory and motor nerves, to injuries of the nerve roots emerging from the spine. It can also be a symptom of more general diseases affecting the central or peripheral nervous system. A precise diagnosis is crucial for determining the appropriate treatment and improving the patient’s quality of life.
Pathology | Clinical Symptoms and Signs | Suspected Diagnosis | Confirmatory Diagnosis |
Sensory neuropathy | Numbness, tingling, loss of sensation, “glove and stocking” distribution | Medical history, neurological examination, symmetrical symptoms | EMG, nerve conduction studies, blood tests |
Motor neuropathy | Muscle weakness, atrophy, fasciculations, loss of reflexes, “glove and stocking” distribution | Medical history, neurological examination, symmetrical symptoms | EMG, nerve conduction studies, blood tests |
Primary muscle disease | Progressive muscle weakness, muscle pain, atrophy, myopathy | Medical history, physical examination, signs of myopathy | Elevated CPK, muscle biopsy, genetic studies |
Cerebellar disease | Ataxia, intentional tremor, dysmetria, incoordination, balance disturbances | Medical history, neurological examination, ataxic gait | Brain MRI, cerebellar coordination tests |
Posterior root injury of C7-C8 | Loss of sensation in the middle finger and little finger, possible weakness in intrinsic hand muscles | Medical history, neurological examination, radicular pain | Cervical MRI, nerve conduction studies |
Posterior root injury of C5-C6 | Loss of sensation in the shoulder and lateral part of the arm, possible weakness in the deltoid and biceps | Medical history, neurological examination, radicular pain | Cervical MRI, nerve conduction studies |
Posterior root injury of L3-L4 | Loss of sensation in the anterior and medial thigh, possible weakness in the quadriceps | Medical history, neurological examination, radicular pain | Lumbar MRI, nerve conduction studies |
Posterior root injury of S1-S2 | Loss of sensation in the posterior thigh and leg, possible weakness in calf muscles | Medical history, neurological examination, radicular pain | Lumbar MRI, nerve conduction studies |
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