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“Under the age of 50, most stroke mimics are migraines, epilepsy, seizures, multiple sclerosis or high blood pressure that causes swelling in the brain,” he said. “Over the age of 50, most patients experiencing a stroke mimic are the result of epilepsy, metabolic derangement or a mass lesion in the brain.”
- Low or High Blood Sugar.
- Bell’s Palsy.
- Brain Tumors.
- Multiple Sclerosis (MS)
- Conversion Disorder.
- Sepsis and Other Infections.
Some stroke survivors can experience seizures. These are most likely to happen within the first few days following a stroke, but your first seizure could occur two or more years later. Some people will have repeated seizures, and be diagnosed with epilepsy.
The most common conditions that can mimic a stroke are seizure, conversion disorder, migraine headache, and hypoglycemia.
A stroke mimic is a situation in which a diagnosis of stroke at admission is not confirmed, and a stroke chameleon is a situation in which a stroke is revealed by clinical symptoms that are not usual in stroke.
A transient ischemic attack (TIA) is a temporary period of symptoms similar to those of a stroke. A TIA usually lasts only a few minutes and doesn’t cause permanent damage. Often called a ministroke, a transient ischemic attack may be a warning.
A transient ischemic attack (TIA), often referred to as a “ministroke,” occurs when part of the brain experiences a temporary lack of blood flow. This causes stroke-like symptoms that usually resolve within 24 hours.
A stroke causes your brain to become injured. The injury to your brain results in the formation of scar tissue, which affects the electrical activity in your brain. Disrupting the electrical activity can cause you to have a seizure. Keep reading to learn more about the connection between strokes and seizures.
A stroke happens when blood flow to the brain is interrupted. A seizure occurs when the brain experiences a surge of electrical activity.
Many conditions have symptoms similar to epilepsy, including first seizures, febrile seizures, nonepileptic events, eclampsia, meningitis, encephalitis, and migraine headaches.
Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure. This includes a high fever, high or low blood sugar, alcohol or drug withdrawal, or a brain concussion.
Frequent causes of transient neurological symptoms that can mimic TIA include: Migraine aura. Seizure.
Elevated blood pressure (BP) at emergency department (ED) presentation and advancing age have been associated with risk of ischemic stroke; however, the relationship between BP, age, and transient ischemic attack/minor stroke (TIA/MS) is not clear.
An ischemic stroke is when blood vessels to the brain become clogged. A hemorrhagic stroke is when bleeding interferes with the brain’s ability to function.
TIA (transient ischemic attack, also sometimes called a “mini-stroke”) begins just like an ischemic stroke; the difference is that in a TIA, the blockage is temporary and blood flow returns on its own. Since blood flow is interrupted only for a short time, the symptoms of a TIA don’t last long – usually less than hour.
Unsurprisingly, factors associated with the greatest odds of having a stroke mimic include a lack of cardiovascular risk factors such as hypertension, hyperlipidaemia or atrial fibrillation.
Among the 94 patients found to present with stroke chameleons, the 5 most common were altered mental status (AMS), syncope, hypertensive emergency, systemic infection, and suspected acute coronary syndrome (ACS).
Stroke chameleons may result in patients not receiving appropriate care. The largest proportions of chameleons were AMS, syncope, hypertensive emergency, systemic infection, and suspected ACS. Patients diagnosed with hypertensive emergency or AMS had an 8% and 7% chance of having an acute stroke.
You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not. You may have an angiogram, CT angiogram, or MR angiogram to see which blood vessel is blocked or bleeding.
When people use the term “ministroke,” what they’re really often referring to is a transient ischemic attack (TIA). A TIA is a brief interruption of blood flow to part of the brain, spinal cord or retina, which may cause temporary stroke-like symptoms but does not damage brain cells or cause permanent disability.
- Sudden lack of balance.
- Temporary loss of basic muscle movement (bladder included)
- Slight memory loss.
- Sudden changes in mood or personality.
Electrolyte imbalances are a common culprit for stroke mimicry, particularly hyponatremia, or low sodium in the blood. This condition is common among elderly patients and results from disordered regulation of sodium and water in the body.
A transient ischemic attack (TIA) is a brief episode during which parts of the brain do not receive enough blood. Because the blood supply is restored quickly, brain tissue does not die as it does in a stroke. These attacks are often early warning signs of a stroke, however.
Transient ischaemic attacks (TIAs) happen when one of the blood vessels that supply your brain with oxygen-rich blood becomes blocked. This interruption in the flow of blood to the brain means it cannot do some of its normal functions properly, leading to symptoms such as slurred speech and weakness.
Seizures: Focal (Partial) Seizures occur when nerve cells in the brain send out sudden, excessive, uncontrolled electrical signals. Focal seizures occur when nerve cells in a part of the brain are involved. The way the child acts during a focal seizure depends on the area of the brain that is affected (See next page).
Decreased blood flow to the cerebrovascular system is the main responsible factor in TIA and other ACEs, but seizures are based on aberrant electrical discharges involving the cerebral cortex.
An ischemic (iss-keem-ik) stroke is the most common type of stroke. A blood vessel gets blocked so that it can’t send blood to a part of the brain. This injures the brain and can cause a seizure.
The most common cause of seizures is epilepsy. But not every person who has a seizure has epilepsy. Sometimes seizures may be caused or triggered by: High fever, which can be associated with an infection such as meningitis.
Seizure mimics stroke signs “When someone is having acute neurological symptoms, including a change in mental status and difficulty with speech, there is a very fine line between a seizure and a stroke,” said Dr. Sachdeva. “Seizure is one of the most common mimics of stroke.
Autonomic Seizures – These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea, which may rise into the throat (epigastric rising), cause stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi), belching, flatulence and vomiting.
Seizures that are not due to epilepsy are sometimes called ‘non-epileptic seizures‘. They can have a physical cause such as low blood sugar (hypoglycaemia) or may be related to how the heart is working. Or they may have a psychological cause.
Dissociative or psychogenic nonepileptic seizures (PNES) are involuntary episodes of movement, sensation, or behaviors (vocalizations, crying, and other expressions of emotion) that do not result from abnormal brain discharges. The seizures can look like any kind of epileptic seizure.
Puckering (jerking) of the lips, twitching of the corners of the mouth, or jaw jerking can also be seen. Sometimes rhythmic jerks of the head and legs may occur. Seizures last 10-60 seconds and typically occur daily. The level of awareness varies from complete loss of awareness to retained awareness.
Unlike other electrolyte alterations, hypokalemia or hyperkalemia rarely causes symptoms in the CNS, and seizures do not occur (8).
A seizure is a single occurrence, whereas epilepsy is a neurological condition characterized by two or more unprovoked seizures.
- a general strange feeling that’s hard to describe.
- a “rising” feeling in your tummy – like the sensation in your stomach when on a fairground ride.
- a feeling that events have happened before (déjà vu)
- unusual smells or tastes.
- tingling in your arms and legs.
Identifiable triggers are associated with syncope and seizures tend to have a longer duration than syncope and are followed by postictal confusion and significant fatigue, although brief periods of confusion have been reported with convulsive syncope.
Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high and require immediate medical attention.
Although it doesn’t cause any obvious symptoms—most people who’ve had a silent stroke have no idea it occurred—the damage does show up on an MRI or CT scan.