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CHARACTERISTICS OF FUNCTIONAL AND ORGANIC STROKE MIMICS
  1. Sergios Gargalas1,
  2. Anthony David2,
  3. Najma Khan-Bourne1,
  4. Paul Shotbolt2,
  5. Robert Weeks1
  1. 1King's College Hospital, London
  2. 2Institute of Psychiatry, Psychology & Neuroscience, King's College London

Abstract

Aim To establish whether the groups of patients with conditions that mimic Stroke display certain characteristics which differentiate them from patients with true Stroke.

Methods All admissions to King's College Hospital's Hyper–Acute Stroke Unit (HASU) over 12 months were reviewed using SINAP data. Subgroups of functional stroke mimics (FSM) and medical mimics (MM) were identified through consensus between experts. Statistical analysis comparing these subgroups to Stroke admissions was performed using Chi2, Kruskal–Wallis and Mann–Whitney methods.

Results FSM patients (N=98) were younger (mean age 49, p<0.001) and mostly females (63.27%, p=0.003). They had the shortest stay on HASU and were more likely to have had MRI during admission. Compared to MM (N=198), FSM were more likely to have had history of Asthma, Back Pain, Migraine or Depression (p=0.001). FSM presented later compared to Strokes (N=904) (latency FSM 4.57 hrs vs. Stroke 2.17 hrs, p<0.001) and were less likely to present with cortical features (Visual disturbances, Dysphasia or Neglect, p<0.001) or facial weakness or numbness. MM were much more likely to present with altered consciousness (MM 15.34% vs. FSM 4.08% vs. Stroke 1.99%, p<0.001).

Conclusion Both functional and medical stroke mimics appear to have distinct features that could aid the diagnostic process.

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