Differential Diagnosis for Left Sided Weakness with History of Seizures
Single Most Likely Diagnosis
- Stroke: Given the left-sided weakness, a stroke is the most likely diagnosis, especially if the seizures are secondary to the stroke. The history of seizures could be indicative of a seizure disorder, but in the context of new-onset left-sided weakness, a stroke is a more immediate concern.
Other Likely Diagnoses
- Traumatic Brain Injury: If the patient has a history of head trauma, a traumatic brain injury could explain both the seizures and the left-sided weakness, depending on the area of the brain affected.
- Brain Tumor: A tumor in the right hemisphere of the brain could cause left-sided weakness and seizures, depending on its location and size.
- Central Nervous System Infections: Infections such as meningitis or encephalitis can cause seizures and focal neurological deficits like left-sided weakness.
- Multiple Sclerosis: Although less common, multiple sclerosis could present with a combination of seizures and focal neurological deficits, including left-sided weakness, especially if there are lesions in the right hemisphere of the brain.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: A sudden onset of seizures and left-sided weakness could be indicative of a subarachnoid hemorrhage, which is a medical emergency requiring immediate intervention.
- Cerebral Venous Thrombosis: This condition can cause seizures and focal neurological deficits, including weakness, and is particularly important to diagnose early due to its potential for severe outcomes if not treated promptly.
- Status Epilepticus: If the seizures are prolonged or recurrent without full recovery in between, status epilepticus should be considered, as it is a life-threatening condition.
Rare Diagnoses
- Mitochondrial Disorders: Certain mitochondrial disorders can cause a combination of seizures and neurological deficits, including weakness, though these are relatively rare.
- Vasculitis: Inflammatory diseases affecting the blood vessels of the brain, such as primary central nervous system vasculitis, can cause a variety of symptoms including seizures and focal weakness, but are less common.
- Paraneoplastic Syndromes: These are rare disorders caused by an immune response to a cancer, which can result in neurological symptoms including seizures and weakness, but are relatively rare and usually associated with known or subsequently diagnosed cancer.