<unk> Seizures/postictal paralysis (Todd paralysis)
Syncope
Subdural hemorrhage
Epidural hemorrhage
Hypoglycemia
Hyponatremia
Meningitis/encephalitis
Hyperosmotic Coma
Labyrinthitis
Drug toxicity
Lithium, phenytoin, carbamazepine
Bell's Palsy
Complicated migraine
Meniere Disease
Demyelinating disease (MS)
Conversion disorder
Transient global amnesia
Giant cell arteritis
Cerebral sinus thrombosis
Lithium, phenytoin, carbamazepine
Neuromuscular weakness
Upper motor neuron:
CVA
Hemorrhagic<unk> Multiple sclerosis
Amyotrophic Lateral Sclerosis (ALS) (UMN & LMN)
Lower motor neuron:
Spinal and bulbar muscular atrophy (Kennedy's syndrome)
Spinal cord disease:
Infection (Epidural abscess)
Infarction/ischemia
Trauma (Spinal Cord Syndromes)
Inflammation (Transverse Myelitis)
Acute flaccid myelitis
Degenerative (Spinal muscular atrophy)
Tumor
Peripheral nerve disease:
Guillain-Barre syndrome
Toxins (Ciguatera)
Tick paralysis
Diabetic peripheral neuropathy
NMJ disease:
Myasthenia gravis crisis
Botulism
Organophosphate toxicity
Lambert-Eaton myasthenic syndrome
Muscle disease:
Rhabdomyolysis
Dermatomyositis
Polymyositis
Alcoholic myopathy
Non-neuromuscular weakness
Can't miss diagnoses:
ACS
Arrhythmia/Syncope
Severe infection/Sepsis
Hypoglycemia
Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
Hypokalemic periodic paralysis
Thyrotoxic periodic paralysis
Respiratory failure
Emergent Diagnoses:
Symptomatic Anemia
Severe dehydration
Hypothyroidism
Polypharmacy
Malignancy
Other causes of weakness and paralysis
Acute intermittent porphyria (ascending weakness)
Upper motor neuron:
CVA
Hemorrhagic<unk> Multiple sclerosis
Amyotrophic Lateral Sclerosis (ALS) (UMN & LMN)
Lower motor neuron:
Spinal and bulbar muscular atrophy (Kennedy's syndrome)
Spinal cord disease:
Infection (Epidural abscess)
Infarction/ischemia
Trauma (Spinal Cord Syndromes)
Inflammation (Transverse Myelitis)
Acute flaccid myelitis
Degenerative (Spinal muscular atrophy)
Tumor
Peripheral nerve disease:
Guillain-Barre syndrome
Toxins (Ciguatera)
Tick paralysis
Diabetic peripheral neuropathy
NMJ disease:
Myasthenia gravis crisis
Botulism
Organophosphate toxicity
Lambert-Eaton myasthenic syndrome
Muscle disease:
Rhabdomyolysis
Dermatomyositis
Polymyositis
Alcoholic myopathy
CVA
Hemorrhagic<unk> Multiple sclerosis
Amyotrophic Lateral Sclerosis (ALS) (UMN & LMN)
Spinal and bulbar muscular atrophy (Kennedy's syndrome)
Infection (Epidural abscess)
Infarction/ischemia
Trauma (Spinal Cord Syndromes)
Inflammation (Transverse Myelitis)
Acute flaccid myelitis
Degenerative (Spinal muscular atrophy)
Tumor
Acute flaccid myelitis
Guillain-Barre syndrome
Toxins (Ciguatera)
Tick paralysis
Diabetic peripheral neuropathy
Myasthenia gravis crisis
Botulism
Organophosphate toxicity
Lambert-Eaton myasthenic syndrome
Rhabdomyolysis
Dermatomyositis
Polymyositis
Alcoholic myopathy
Can't miss diagnoses:
ACS
Arrhythmia/Syncope
Severe infection/Sepsis
Hypoglycemia
Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
Hypokalemic periodic paralysis
Thyrotoxic periodic paralysis
Respiratory failure
Emergent Diagnoses:
Symptomatic Anemia
Severe dehydration
Hypothyroidism
Polypharmacy
Malignancy
Other causes of weakness and paralysis
Acute intermittent porphyria (ascending weakness)
ACS
Arrhythmia/Syncope
Severe infection/Sepsis
Hypoglycemia
Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
Hypokalemic periodic paralysis
Thyrotoxic periodic paralysis
Respiratory failure
Hypokalemic periodic paralysis
Thyrotoxic periodic paralysis
Symptomatic Anemia
Severe dehydration
Hypothyroidism
Polypharmacy
Malignancy
Acute intermittent porphyria (ascending weakness)
Stroke 
Stroke
Subarachnoid hemorrhage
Seizures/postictal paralysis 
Ischemic stroke
Syncope
Hemorrhagic stroke
Subdural hemorrhage