Diagnostic challenge--is this really a stroke?
BACKGROUND
Although acute stroke most commonly presents with hemiparesis, facial weakness and dysphasia, these symptoms can sometimes be the atypical presentations of other conditions which may be difficult to diagnose.


OBJECTIVE
This article presents three cases of stroke mimics and discusses how to improve accuracy in diagnosing stroke in the primary care setting.


CONCLUSIONS
Stroke is a medical emergency and urgent hospital transfer is vital. Hypoglycaemia, hyperglycaemia, epilepsy, multiple sclerosis, hemiplegic migraine, intracranial tumours or infection (meningitis/encephalitis/abscess) can all mimic stroke. The Los Angeles Prehospital Stroke Screen (LAPSS) consists of four history items, a blood glucose measure, and three examination items designed to detect unilateral motor weakness. It can be utilised to improve the accuracy in diagnosing stroke and stroke mimics in general practice.
Ng
Ching Luen
CL
Kowloon West Cluster, Hospital Authority, Hong Kong. chingluen@yahoo.com.hk
D000038:Abscess / Q000175:diagnosis; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis; D004827:Epilepsy / Q000175:diagnosis; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis; D007003:Hypoglycemia / Q000175:diagnosis; D008297:Male; D008581:Meningitis / Q000175:diagnosis; D020325:Migraine with Aura / Q000175:diagnosis; D009103:Multiple Sclerosis / Q000175:diagnosis; D020521:Stroke / Q000175:diagnosis*; D013997:Time Factors