Differential Diagnosis for Vision Loss and Paralysis on the Same Side

• Single Most Likely Diagnosis
  • Stroke (Ischemic or Hemorrhagic): This is the most likely diagnosis as it can cause sudden vision loss and paralysis on the same side, depending on the location and extent of the brain injury.
• Other Likely Diagnoses
  • Multiple Sclerosis: This condition can cause vision loss and paralysis, although the symptoms may not always occur simultaneously or on the same side, it's a possibility due to the unpredictable nature of the disease.
  • Optic Neuritis with Concurrent Stroke or TIA: Inflammation of the optic nerve can cause vision loss, and if it occurs with a stroke or transient ischemic attack (TIA), it could result in paralysis on the same side.
• Do Not Miss Diagnoses
  • Brain Tumor (e.g., Glioma, Meningioma): Although less common, a brain tumor pressing on the optic nerve and adjacent motor areas can cause vision loss and paralysis. Missing this diagnosis could be fatal.
  • Cavernous Sinus Thrombosis: This rare condition involves a blood clot in the cavernous sinus and can cause vision loss and paralysis due to its strategic location affecting cranial nerves.
  • Giant Cell Arteritis: This condition can cause vision loss due to ischemia of the optic nerve and, if involving other arteries, could potentially lead to paralysis, making it crucial not to miss.
• Rare Diagnoses
  • Susac Syndrome: A rare condition characterized by microangiopathic changes in the brain, retina, and inner ear, leading to a combination of vision loss, hearing loss, and sometimes paralysis.
  • Mitochondrial Myopathies (e.g., Kearns-Sayre Syndrome): These are a group of disorders that can affect many parts of the body, including the eyes and muscles, potentially leading to vision loss and paralysis, although this presentation would be uncommon.