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Acute alcohol intoxication may cause delay in stroke treatment - case reports
Tamas Arokszallasi1, Eszter Balogh2, Laszlo Csiba2,3
1Department of Neurology, Faculty of Medicine, University of Debrecen, Moricz Zs. krt 22, Debrecen, 4032, Hungary. aroksztamas@gmail.com.
BMC Neurology
|January 31, 2019
Summary
Alcohol intoxication can mimic vertebrobasilar stroke symptoms, complicating diagnosis. Promptly consider stroke in patients with worsening neurological signs, especially after alcohol consumption, to ensure timely reperfusion therapy.
Area of Science:
- Neurology
- Emergency Medicine
- Toxicology
Background:
- Acute alcohol intoxication and vertebrobasilar stroke share overlapping symptoms like double vision, nystagmus, dysarthria, and ataxia.
- This symptom overlap presents a diagnostic challenge, potentially leading to misdiagnosis of stroke as alcohol intoxication.
Observation:
- Three cases illustrate how alcohol consumption can mask or delay the diagnosis of vertebrobasilar stroke.
- Delayed diagnosis in these cases led to missed opportunities for crucial reperfusion therapies.
- Worsening symptoms, dysphagia, hemiparesis, and disproportionately severe signs despite alcohol consumption were key indicators.
Findings:
- Alcohol intoxication can significantly interfere with the accurate and timely diagnosis of vertebrobasilar stroke.
- Attributing stroke symptoms solely to alcohol can result in critical delays in initiating stroke-specific treatments.
- Early recognition of stroke is crucial, even in the presence of alcohol consumption, to prevent irreversible neurological damage.
Implications:
- Healthcare providers must maintain a high index of suspicion for stroke in patients presenting with neurological deficits after alcohol consumption.
- Prompt neurological assessment and imaging are vital when stroke is suspected, regardless of alcohol levels.
- Timely administration of reperfusion therapy, such as thrombolysis, can significantly improve outcomes for stroke patients.
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