Published: Tuesday 15 May 2018

A ‘stroke mimic’ is any condition which presents with stroke-like symptoms, but is actually a different condition.

Published in the European Journal of Emergency Medicine (EJEM), a new review of the existing research sheds light on how frequently patients with a stroke mimic condition present for emergency care as having a stroke.

The review looked at those who present with a stroke mimic pre-hospital (ie to paramedics) and for thrombolysis treatment in hospital, and also what features on clinic presentation might help diagnose stroke mimic conditions, and what the common causes are.

The review included 79 studies primarily from North America (34) and Europe (29), and which included 147,779 patients overall. 

The researchers estimate that 19% of stroke patients from across the studies had a mimic condition (taking the ‘median’ average value across studies).

For those patients who presented with symptoms pre-hospital, the equivalent estimated rate of stroke mimics was 27% and for patients thrombolysed in hospital this figure was 10%.

Overall, the most frequently reported causes of stroke mimics were found to be seizures, migraines and psychiatric disorders. Stroke mimics were also more common with younger age and female gender.

The range of mimic diagnoses, a lack of clear differentiating characteristics of these conditions compared to stroke, and the short treatment window for ischaemic (clot-type) stroke creates challenges for early identification of mimics.

The early, correct diagnosis of stroke mimics helps stroke services run more efficiently to maximise stroke patient care, and also ensures that those with mimic conditions get the urgent care they may need too.

About the researcher:

Lead author, Graham McClelland is a research paramedic and Stroke Association Postgraduate Fellow (TSA PGF 2015-01).

He recently presented his fellowship work at the EMS999 Research Forum Conference in Stirling, Scotland, which is the leading UK conference for emergency medical services research. He was awarded the prize for highest quality research which includes being supported to attend and present his research at the Paramedics Australasia International conference (PAIC 2018).

Find out more about Graham at the Newcastle University website.      

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