Causes of Hemiplegia - Differential Diagnosis Algorithm

Cerebral Hemisphere (Contralateral motor cortex)

 • Aphasia

 • Apraxia

 • Agnosia

 • Agraphia

 • Acalculia

 • Alexia

 • Anomia

 • Anosognosia

 • Asterognosia

 • Seizures

 • Personality Changes

 • Cognition/Confusion, Dementia

 • +/- Sensory Loss

Contralateral/Sub-Cortical (Corona radiata, Internal Capsule)

 • May be without sensory loss

 • May be combined with contralateral sensory loss

Brain Stem

 • Diplopia

 • Dysarthria

 • Dysphagia

 • Ptosis

 • Decreased Level of Consciousness

 • Cranial Nerve Palsies

 • 'Crossed' Sensory Findings: ipsilateral facial and contralateral extremity findings

Unilateral Spinal Cord Lesions Above ~C5

 • Brown-Sequard Syndrome (sensory loss to pain and temperature contralateral to weakness, vibration and proprioception loss ipsilateral to weakness)



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