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Published on: January 15, 2017
Stroke Mimics: Experience of a Moroccan Stroke Unit
Naima Chtaou1, Siham Bouchal1, Aouatef E L Midaoui1
1Department of Neurology, Hassan II University Teaching Hospital, Fez, Morocco; Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
Background:
Stroke mimic is a medical condition presenting with acute neurological deficit and simulate real stroke. The objective of this study was to evaluate the frequency and the various etiologies of stroke mimics in our center.
Methods:
We retrospectively reviewed the Thrombolysis Alert registry and we studied the frequency and characteristics of patients with stroke mimic.
Results:
Among 673 patients who were admitted to the emergency department within 4.5 hours for sudden focal neurological deficit suggestive of acute stroke, 105 patients (15.6 %) had a stroke mimic. The mean age of patients with mimics and brain strokes were 66.3 and 64.8, respectively. The mean Onset-to-door time was 136.82 minutes and the mean door-to-imaging time was 32.63 minutes in stroke mimics. Seizure (28.5%) was the most common diagnosis of stroke mimics followed by conversion disorder (25.7%).
Conclusions:
Stroke mimic is frequent and heterogeneous entity that can be difficult to identify. Fortunately, most previous studies show no harmful effects when using thrombolysis in a stroke mimic.
Insights
Stroke mimics, conditions mimicking stroke, are frequent (15.6%) and diverse. Seizures and conversion disorder were the most common causes, highlighting the need for accurate diagnosis in emergency settings.
Area of Science:
- Neurology
- Emergency Medicine
Background:
- Stroke mimics present with acute neurological deficits that resemble actual strokes.
- Accurate identification of stroke mimics is crucial for appropriate patient management.
Purpose of the Study:
- To determine the frequency and etiological characteristics of stroke mimics at our medical center.
- To analyze the diagnostic patterns and patient demographics associated with stroke mimics.
Main Methods:
- Retrospective review of the Thrombolysis Alert registry.
- Analysis of patient data including demographics, onset-to-door time, and door-to-imaging time.
Main Results:
- 105 out of 673 patients (15.6%) admitted for suspected stroke were identified as stroke mimics.
- The most common causes of stroke mimics were seizure (28.5%) and conversion disorder (25.7%).
- Mean age of patients with mimics was 66.3 years; onset-to-door time averaged 136.82 minutes.
Conclusions:
- Stroke mimics are a common and complex diagnostic challenge in emergency departments.
- While heterogeneous, stroke mimics do not appear to be harmed by thrombolytic therapy, based on prior studies.
