Welcome to your stroke differential diagnosis guide!

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Differential Diagnosis

    Other conditions should be considered when considering the diagnosis of a stroke, including:
  • Hypoglycemia,
  • Migraine headache,
  • Space-occupying lesions (abscess or tumor), and
  • Seizures (Todd's Paralysis).

Hypoglycemia:  Hypoglycemia may cause a wide array of symptoms, those potentially mimicking stroke include but are not limited to headache, shaking or trembling, tingling or numbness of the skin, convulsions, and tiredness or weakness (Goodman & Snyder, 2007).  Assessing serum glucose level can help to rule out hypoglycemia (Agranoff, 2011).

Migraine headache:  Migraine headaches may be preceded by visual changes, motor weakness, dizziness, and paresthesias.  Since migraines can present with paralysis or weakening of one side of the body mimicking a stroke, a medical examination is required to diagnose migraines (Goodman & Synder, 2007).
Space-occupying lesion: Space occupying lesions may mimic stroke by exhibiting headaches, changes in mental status, deficits in speech, weakness, ataxia or disturbance in gait.  Additionally, cerebral disturbances evolve gradually over days or weeks, which is much longer than the period of a stroke (Tsementzis, 2000).  A computed tomography (CT scan) can be used to show a large cortical stroke, an old lacune, or a space-occupying lesion.

Seizures:  Examination immediately after a seizure may reveal lethargy, sleepiness, confusion, headache, muscle soreness, and weakness on one side of the body that later resolves (Todd's paralysis).  To help rule out seizure, an EEG should be performed.