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Transient ischemic attack versus transient ischemic attack mimics: frequency, clinical characteristics and outcome
Margareth Amort1, Felix Fluri, Juliane Schäfer
1Stroke Unit and Department of Neurology, University Hospital Basel, Basel, Switzerland. mamort@uhbs.ch
Cerebrovascular Diseases (Basel, Switzerland)
|May 27, 2011
Summary
Approximately 1 in 5 suspected transient ischemic attacks (TIA) are actually TIA mimics. Unilateral paresis suggests TIA, but other common symptoms like memory loss or headache may indicate a mimic, with mimics having a better short-term prognosis.
Area of Science:
- Neurology
- Emergency Medicine
- Clinical Diagnostics
Background:
- Distinguishing transient ischemic attack (TIA) from TIA mimics is challenging due to insufficient clinical evidence.
- Accurate differentiation is crucial for appropriate patient management and prognosis.
Purpose of the Study:
- To compare the frequency, clinical characteristics, and outcomes of TIA and TIA mimics.
- To identify clinical features that best differentiate TIA from TIA mimics.
Main Methods:
- Prospective, single-center emergency department cohort study over 2 years.
- Comparison of 248 patients with TIA and 55 patients with TIA mimics.
- Analysis of clinical features, symptom presentation, and short-term outcomes.
Main Results:
- TIA mimics comprised 18.2% of suspected TIA cases, with epileptic seizures and migraine being most common.
- Unilateral paresis was less likely in TIA mimics (OR 0.35).
- Memory loss (OR 9.17), headache (OR 3.71), and blurred vision (OR 2.48) increased the likelihood of TIA mimics. Aphasia, dysarthria, sensory loss, and symptom duration did not aid differentiation.
- Patients with TIA mimics had no stroke, recurrent TIA, or myocardial infarction at 3 months, unlike TIA patients.
Conclusions:
- Nearly 1 in 5 patients with suspected TIA were diagnosed with a TIA mimic.
- Unilateral paresis is indicative of TIA, whereas other common clinical variables lack discriminatory power.
- TIA mimics exhibit a more favorable short-term prognosis compared to actual TIAs.
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