[Stroke: when the diagnosis is wrong].
BACKGROUND
There is a lack of knowledge of stroke symptoms in the population and among health professionals. Many non-cerebrovascular diseases present with a strokelike clinical picture. The present study focuses on non-cerebrovascular conditions that were referred to a neurological acute stroke unit as strokes.


METHODS
In an observational study, 354 consecutive patients who presented to the stroke unit with a diagnosis of stroke were evaluated. Patients were assessed by neurologists and classified as non-stroke patients or true stroke patients.


RESULTS
Eighty-eight were non-stroke patients (25%), who were younger than the true strokes (65.5 vs 71.5). Clinical features were falls (23%), sensory impairment (19%), vertigo (13%), loss of consciousness (11%) and confusion (9%). Half of the non-stroke diagnoses were either migraine, infection, postural vertigo or sequelae after a previous stroke. In 25% another neurological disease was present, such as epilepsy, cranial nerve disorder, neuropathy, transient global amnesia or demyelinating disease. There were 6 patients with previous stroke among the 11 non-stroke patients who had a final diagnosis of infection.


CONCLUSIONS
Misdiagnosis of stroke is common among non-neurologists. Non-stroke patients often have another neurological disease. All stroke patients should be seen by a neurologist in the early phase.
Nevrologisk avdeling, Akershus universitetssykehus, 1474 Nordbyhagen. ole.morten.ronning@ahus.no
Ole Morten
OM
Rønning
Bente
B
Thommessen
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis*; D020521:Stroke / Q000175:diagnosis*