title: Transient ischemic attack versus transient ischemic attack mimics: frequency, clinical characteristics and outcome.
abstract: BACKGROUND
  There is insufficient evidence regarding which clinical features are best suited to distinguish between transient ischemic attack (TIA) and disorders mimicking TIA (TIA mimics).
  
  
  METHODS
  We compared the frequency, clinical characteristics and outcome of patients with TIA and TIA mimics in a prospective, single-center emergency department cohort over 2 years.
  
  
  RESULTS
  Of 303 patients, 248 (81.8%) had a TIA and 55 (18.2%) had TIA mimics. Epileptic seizures (26/55; 43.7%) and migraine attacks (13/55; 23.6%) were the most common TIA mimics. In patients presenting with unilateral paresis, TIA mimics were less likely than in patients without unilateral paresis [odds ratio (OR) 0.35, 95% confidence interval (CI) 0.17-0.68]. Memory loss (OR 9.17, 95% CI 2.89-32.50), headache (OR 3.71, 95% CI 1.07-12.78) and blurred vision (OR 2.48, 95% CI 0.90-6.59) increased the odds of TIA mimics. Once these clinical features were taken into account, neither aphasia, dysarthria, sensory loss, blood pressure values nor the duration of symptoms were found to improve explanation of the underlying status. At 3 months, stroke, recurrent TIA and myocardial infarction were absent in patients with TIA mimics but occurred in 13 (5.2%), 20 (8.1%) and 3 (1.2%) TIA patients, respectively.
  
  
  CONCLUSIONS
  About 1 in every 5 patients with suspected TIA had a TIA mimic. Paresis suggested TIA, while other clinical variables used in risk assessment scores after TIA were not shown to distinguish between the two entities. Patients with TIA mimics had a better short-term prognosis.
authors: Stroke Unit and Department of Neurology, University Hospital Basel, Basel, Switzerland. mamort@uhbs.ch
authors: Margareth
authors: M
authors: Amort
authors: Felix
authors: F
authors: Fluri
authors: Juliane
authors: J
authors: Schäfer
authors: Florian
authors: F
authors: Weisskopf
authors: Mira
authors: M
authors: Katan
authors: Annika
authors: A
authors: Burow
authors: Heiner C
authors: HC
authors: Bucher
authors: Leo H
authors: LH
authors: Bonati
authors: Philippe A
authors: PA
authors: Lyrer
authors: Stefan T
authors: ST
authors: Engelter