This page is about stroke symptoms that are not caused by a stroke.
Stroke symptoms can sometimes be due to other health conditions that affect the brain or body, known as a stroke mimic. It’s also possible for a stroke to have symptoms that resemble other conditions.
On this page:
Diagnosing a stroke mimic
Functional neurological symptoms
Diagnosing functional neurological symptoms and FND
Diagnosing a stroke mimic
When someone has stroke symptoms, they should have emergency medical care within a few hours to give the best chance of recovery. The medical team carries out scans and checks to discover if it’s a stroke, and what type of stroke.
In around 20% of cases, the symptoms aren’t due to a stroke. The person will have more checks and tests to find out what’s wrong. Some of the most common stroke mimics are seizures, migraine, fainting, serious infections and functional neurological disorder (FND). Once the person is diagnosed, they can have treatment or support to manage their symptoms.
Functional neurological disorder (FND)
FND (sometimes called ‘functional stroke’ or a ‘functional stroke mimic’) describes a problem with how the brain sends and receives information to the rest of the body. The symptoms of FND are real, but are called functional because they are caused by a disorder of the nervous system, rather than damage to the brain.
The symptoms of FND may include:
- Loss of motor control.
- Sensory symptoms.
- Speech problems.
- Visual symptoms.
- Cognitive problems.
- Bladder and bowel problems.
FND can be diagnosed by a neurologist or a neuropsychiatrist following a neurological examination. This will likely involve checking a person’s motor and sensory skills, and their reflexes. A neurologist is a doctor who deals with disorders of the nervous system and a neuropsychiatrist is a doctor who deals with mental disorders caused by damage to the nervous system, typically the brain.
Some people worry that being diagnosed with FND means that doctors think that it’s “all in their head” or that they are “pretending”. This is not true. The symptoms of FND are real. They are often assumed to be connected to a psychological problem such as trauma or stress. This may be a risk factor, but it is not the cause of all cases.
There are a number of diagnostic signs that a person has FND and their nervous system is functioning abnormally. For example, ‘Hoover’s sign’ is where someone with leg weakness might have trouble with conscious movements such as walking, but if they are asked to lift their unaffected leg whilst in a seated or lying down position, the weak leg produces a reflex (unconscious) movement by pushing down from the hip. This shows that the nerves are operating, but the brain is not fully in control of the muscle movement.
FND can be treated. Over time, many people find that their symptoms improve or resolve completely.
Other approaches to managing FND can include strategies for managing symptoms. Specialist physiotherapy and occupational therapy can help, and psychological support including cognitive behavioural therapy (CBT) can help with managing some symptoms and promoting self-care.
For more information about FND causes, diagnosis and treatment visit the FND Hope UK.