A 35 years old male presents with a partial seizure involving jerky movements of his right side of his face. He reports having had left-sided headaches for a few months and clumsiness of his right hand, and on further questioning, admits others have the past few months. On examination, he is awake and oriented. He has a subtle facial droop and pronator drift on the right side. What are the most important differential diagnoses?

Of the relevant differential diagnoses for sudden onset neurological symptoms, brain tumor is the most serious and therefore the most important to rule out. Other causes include encephalitis, myasthenia gravis, Guillain-Barre syndrome, Lambert-Eaton syndrome and poliomyelitis.

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This post was written by Omar Rifai