Differential Diagnosis for Aphasia and Left Facial Weakness
- Single most likely diagnosis
- Stroke (ischemic or hemorrhagic): This is the most common cause of sudden onset aphasia and facial weakness, typically due to a lesion in the left hemisphere of the brain, particularly in the middle cerebral artery territory.
- Other Likely diagnoses
- Transient Ischemic Attack (TIA): Often referred to as a "mini-stroke," TIAs have similar symptoms to a stroke but are temporary, lasting less than 24 hours. The symptoms of aphasia and facial weakness could be part of a TIA.
- Brain Tumor: Both primary and metastatic brain tumors can cause focal neurological deficits such as aphasia and facial weakness, depending on their location.
- Encephalitis: Inflammation of the brain tissue, which can be caused by viral or bacterial infections, leading to symptoms like aphasia and facial weakness if the left hemisphere is involved.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cerebral Venous Thrombosis: A blood clot in the brain's venous sinuses can cause stroke-like symptoms, including aphasia and facial weakness, and requires prompt anticoagulation.
- Reversible Cerebral Vasoconstriction Syndrome (RCVS): A condition that mimics stroke but is caused by temporary narrowing of blood vessels in the brain. It can lead to severe complications if not recognized and treated appropriately.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can present with a variety of neurological symptoms, including aphasia and facial weakness, especially if there is increased intracranial pressure or brain edema.
- Rare diagnoses
- Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes (MELAS): A rare genetic disorder that can cause stroke-like episodes, including aphasia and facial weakness, due to mitochondrial dysfunction.
- CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy): A rare hereditary condition leading to stroke and dementia, which could present with aphasia and facial weakness among other symptoms.
- Multiple Sclerosis: Although more commonly associated with optic neuritis, spinal cord lesions, and brainstem lesions, multiple sclerosis can rarely present with aphasia and facial weakness if there are lesions in the appropriate areas of the brain.