A patient with hypertension and atrial fibrillation presents with transient neurological symptoms. What is the most likely diagnosis?

The most likely diagnosis in this scenario is a transient ischemic attack (TIA). A TIA is characterized by transient neurological symptoms that typically resolve within 24 hours and is often referred to as a "mini-stroke." The key features that suggest this diagnosis in the context provided include the patient's history of hypertension and atrial fibrillation, both of which significantly increase the risk for cerebrovascular events like TIAs.

In atrial fibrillation, there is a potential for thrombus formation in the left atrial appendage, which can lead to embolic strokes. Therefore, a patient with this arrhythmia who presents with transient neurological symptoms raises a strong suspicion for a TIA, as the symptoms generally follow the vascular territory affected and may include weakness, numbness, or difficulty speaking.

Other potential diagnoses such as focal seizures or migraines may also present with neurological symptoms but are less likely given the context. Focal seizures often produce consistent symptoms that last longer and may not resolve as spontaneously as TIA symptoms. Migraine headaches could also present with transient symptoms; however, they are usually accompanied by other headache features and are less likely in the presence of the comorbid conditions. Thus, in the context of the patient's background and presenting symptoms, T