Table 1 Non-vascular disease processes producing some of the clinical picture akin to a stroke
From: Methyl iodide poisoning presenting as a mimic of acute stroke: a case report
Conditions | Comments |
|---|---|
A. Nervous system | |
Epilepsy | Todd's palsy presents with postictal confusion, transient focal motor and sensory symptoms, extra-ocular movement deficits; witness and/or history is important and has a resolving course. |
Hemiplegic migraine [4] | Headache, impaired consciousness, ataxia and hemi paresis; stereotypical attacks can occur. |
Infection(meningitis/encephalitis/abscess) | Headache, hemiparesis, altered consciousness; systemic disturbances common |
Intracranial mass lesions [14] | Subdural hematoma, tumors and abscesses can present with headache and abrupt onset focal neurological symptoms. Fever, weight loss, systemic disturbances are common. |
Encephalopathy | Can present with altered behavior, cognition, coma, aphasia, focal motor and sensory deficits, homonymous hemianopia and hemi hyperreflexia. |
Multiple sclerosis | Visual and long tract neurological symptoms; recurrences of neurological deficits in space and time are common. |
Myasthenia gravis (rare) | Ocular myasthenia and weakness mimic stroke; variable and diurnal fluctuation. |
B. Non-nervous system | |
Syncope | Usually due to hypotension or arrhythmia; Vertebrobasilar insufficiency can cause syncope. |
Sepsis | Various neurological presentations, systemic disturbances common |
Hyponatremia, hyperglycemia, hypoglycemia [5] | Can present with fluctuating neurological symptoms, aphasia, cortical blindness and so on; an initial blood sugar check is vital. |
Functional disorders | Conversion disorders can have hemiparesis, blindness, speech disturbances; psychiatric history |
Industrial toxins, drug overdose | Conversion disorders can have hemiparesis, blindness, speech disturbances; psychiatric history |