People are misdiagnosed with stroke more often than you think because stroke mimics so many conditions – including cancer.
“Most errors in the misdiagnosis of stroke occur when patients can’t provide a past medical history due to impaired speech or altered mental status,” states the Journal of Emergency Medical Services, Feb. 2011.
Because stroke can cause so many different symptoms (pamphlets and awareness campaigns do not list every single symptom — and there are actually so many), this neurologically-based condition has many mimickers.
Conditions that Mimic Ischemic Stroke
• Bell’s palsy. This odd condition involves trauma to the facial (seventh cranial) nerve, which controls facial movement.
One side of the face is affected at a time in terms of drooping or paralysis, which really makes this disorder a great stroke mimicker.
• Brain abscess. A pus-filled area in the brain, depending on location, can bring on symptoms that resemble that of a stroke.
• Brain cancer (primary, e.g., glioblastoma, or metastasis, e.g., melanoma, breast, lung)
• Chronic subdural hematoma. This is a slow bleeding in the brain usually caused by head trauma. Symptoms are remarkably similar to that of a stroke, but a CT scan will detect the bleeding.
• Diabetes. Common symptoms include excessive thirst and urination, and weight loss despite eating more due to increased hunger. But it can also cause blurred vision and weakness.
• Hepatic encephalopathy. A malfunctioning liver can result in unfiltered body toxins getting into the circulation and reaching the brain.
• Hypocalcaemia. This means low circulating calcium.
• Hypoglycemia: low blood sugar
• Hyponatremia: low sodium level
• Hypothyroidism: underactive or “low” thyroid
• Labyrinthitis: inner ear infection
• Meniere’s disease: inner ear disorder
• Meningoencephalitis. This is two illnesses: meningitis with encephalitis. Meningitis is inflammation of the meninges, the thin tissue that covers the brain. Encephalitis is inflammation of the brain.
• Migraines. “Some types of migraines could mimic strokes — for some people in addition to headaches with migraines, there can be visual changes, weakness and numbness,” says Susan L. Besser, MD, with Mercy Medical Center, Baltimore; Diplomate, American Board of Obesity Medicine and board certified by the American Board of Family Medicine.
• Myasthenia gravis: a neurological disorder that affects the muscles.
• “Multiple sclerosis (MS) can mimic stroke with weakness of limbs and visual changes,” says Dr. Besser.
• Panic attack. Dr. Besser explains, “For some people panic attacks can cause temporary changes similar to stroke symptoms.”
• Paresthesia or numbness of unknown causes
• Psychogenic pseudostroke (no physical cause; patient either makes up the symptoms for attention or financial gain/avoiding responsibility or unconsciously creates symptoms to cope with stress)
• Respiratory infection
• Rheumatoid meningitis: a rare complication of rheumatoid arthritis.
• Seizure/Todd’s paralysis: weakness in a part of the body following a seizure
• Spinal cord injury. “Obviously a spinal cord injury which causes paralysis has symptoms similar to stroke,” says Dr. Besser.
• Thyrotoxicosis: excess thyroid hormone
• Uremia. This is what happens in end stage chronic kidney disease or acute kidney injury. Urea, which is supposed to be excreted by urine, which is made by the kidneys, instead ends up in the blood circulation and is toxic to the brain.
• Vertebrobasilar insufficiency. This is insufficient blood flow to the back region of the brain, caused by arterial plaque buildup.
Dr. Besser provides comprehensive family care, treating common and acute primary conditions like diabetes and hypertension. Her ongoing approach allows her the opportunity to provide accurate and critical diagnoses of more complex conditions and disorders.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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