Differential Diagnosis for Right Facial Dropping and Void of Words
Single most likely diagnosis
- Left Middle Cerebral Artery (MCA) stroke: This is the most likely diagnosis because the left MCA supplies the areas of the brain responsible for language (Broca's and Wernicke's areas) and motor function for the right side of the face. A stroke in this area would result in right facial drooping and aphasia (void of words).
Other Likely diagnoses
- Left Anterior Cerebral Artery (ACA) stroke: Although less likely than an MCA stroke, an ACA stroke could also cause right lower limb weakness and possibly some language deficits, depending on the specific area affected.
- Left Internal Carotid Artery (ICA) occlusion: This would likely cause a more extensive stroke, affecting multiple areas of the left hemisphere, including those responsible for language and motor function.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Left Posterior Cerebral Artery (PCA) stroke with crossed cerebral diaschisis: Although a PCA stroke typically affects vision, it can also cause language deficits if there is crossed cerebral diaschisis (a condition where one area of the brain affects another area on the opposite side).
- Moyamoya disease: A rare condition caused by narrowing or blockage of the internal carotid artery and its branches, which can lead to stroke or other neurological symptoms.
- Cerebral vasculitis: Inflammation of the blood vessels in the brain, which can cause stroke-like symptoms.
Rare diagnoses
- CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy): A rare genetic disorder that affects the blood vessels in the brain, leading to subcortical strokes and dementia.
- Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS): A rare mitochondrial disorder that can cause stroke-like episodes, among other symptoms.