Differential Diagnosis for Sudden Right-Sided Weakness and Slurred Speech
Single Most Likely Diagnosis
- Ischemic Stroke: The sudden onset of right-sided weakness and slurred speech strongly suggests a stroke, with ischemic stroke being the most common type. This condition occurs when a blood vessel supplying blood to the brain is obstructed, leading to tissue damage.
Other Likely Diagnoses
- Hemorrhagic Stroke: Although less common than ischemic stroke, hemorrhagic stroke (bleeding within or around the brain) can also present with sudden focal neurological deficits like weakness and speech changes.
- Transient Ischemic Attack (TIA): Often referred to as a "mini-stroke," TIA has similar symptoms to a stroke but resolves within 24 hours. It's a warning sign for a future stroke and requires immediate medical attention.
- Seizure: A seizure can cause transient focal neurological symptoms, including weakness and speech disturbances, especially if it involves the motor or language areas of the brain.
Do Not Miss Diagnoses
- Brain Tumor: Although less likely, a brain tumor could cause sudden symptoms if there's a hemorrhage or significant increase in intracranial pressure. Missing this diagnosis could be catastrophic.
- Meningitis or Encephalitis: Infections like meningitis or encephalitis can present with a variety of neurological symptoms, including sudden weakness and speech changes, especially if the infection involves the brain directly.
- Subarachnoid Hemorrhage: This condition, often due to an aneurysm rupture, can present with sudden severe headache and sometimes focal neurological deficits.
Rare Diagnoses
- Multiple Sclerosis (MS): MS can have a wide range of neurological symptoms, including weakness and speech difficulties, but the onset is typically more gradual and less likely to be unilateral.
- Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes (MELAS): A rare genetic disorder that can cause stroke-like episodes, including sudden weakness and speech changes, often with a more gradual onset and other systemic symptoms.
- Cerebral Vasculitis: Inflammation of the blood vessels in the brain can cause a variety of neurological symptoms, including sudden focal deficits, but is much less common and often associated with systemic symptoms or other autoimmune conditions.