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Parkinsonism or Other Movement Disorders Presenting as Stroke Mimics
Cheng-Yang Hsieh1, Chih-Hung Chen2, Sheng-Feng Sung3
1Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan.
Acta Neurologica Taiwanica
|April 7, 2017
Summary
Movement disorders like parkinsonism can mimic strokes, leading to misdiagnosis in emergency departments. Early identification is crucial to avoid unnecessary treatments such as thrombolysis.
Area of Science:
- Neurology
- Emergency Medicine
Background:
- Patients with movement disorders, including parkinsonism, may present with acute neurological changes mimicking stroke.
- Misdiagnosis as a hyperacute stroke can lead to inappropriate stroke code activation and interventions.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of patients with parkinsonism or other movement disorders who present as stroke mimics.
- To analyze cases where stroke codes were activated due to misdiagnosis of movement disorders.
Main Methods:
- A retrospective case-series study was conducted.
- Data were collected from patient charts and stroke code registries at two high-volume stroke centers in Southern Taiwan.
Main Results:
- Seven male patients (mean age 67.0 years) with focal myoclonus, focal dystonia, or parkinsonism were identified.
- Presenting symptoms included acute consciousness disturbance or motor weakness, with six experiencing motor deficits (five unilateral).
- Three patients were initially misdiagnosed with stroke; one received thrombolytic therapy without complications.
Conclusions:
- Movement disorders can rarely present as stroke mimics, triggering stroke code activation.
- Neurologists must differentiate these conditions from actual strokes to prevent unnecessary thrombolysis.
- Accurate etiological clarification is essential for patients with acute neurological deficits and suspected movement disorders.