Mental Disorders and Illness

Stroke mimics (SM) can be diffi cult to distinguish from real stroke. Misdiagnosis of stroke leads to unnecessary tests, harmful intervention, and increased cost. We aimed to study the prevalence and nature of SMs among Saudi patients who came to the emergency department with sudden neurological defi cit and suspected stroke. We retrospectively reviewed records of all patients with suspected stroke admitted to the stroke unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia from February 2016 to July 2018. We compared SM to real strokes. Logistic regression analysis was conducted to identify the potential predictors of SMs. This study was approved

by local institutional review board. Of the 1,063 patients, 131 (12.3%) had SM.

The most common causes were peripheral vestibular disorder (27.4%) followed by psychogenic causes (24.4%). Stroke mimics were more common among younger individuals and women, and individuals with SM were less likely to have arterial hypertension, diabetes, and to be smokers. At discharge, individuals with SM were more likely to be independent at discharge, had milder defi cits, and shorter hospital stays. Predictors of SM were young age, female gender, mild defi cit at presentation, and good functional status prior to stroke. Stroke mimics are common among suspected strokes. Practicing physicians should consider potential diagnostic errors, particularly in the hyperacute phase of stroke.