What diseases do lay people often confuse stroke with?

What diseases do lay people often confuse stroke with?
Photo source: Getty images

In the world there are diseases with common features. Therefore, it is not always easy to distinguish them from each other. Often, because of this, the patient is incorrectly treated. Differential diagnosis is a procedure involving examination methods that help the doctor to establish the correct diagnosis.

Stroke also resembles other diseases in certain ways. Which are the most common?

  • Did you wake up in the morning with numbness in half of your body or upper limb?
    Maybe you just slept badly.
  • Do you have a hangover, headache, dizziness and vomiting?
    Who doesn't?
  • Do you have hyperventilation tetany or tetanic syndrome and your upper limbs and lips tingle when you get agitated?
    Don't worry, you definitely don't have a stroke.
  • Do you have an elderly relative at home with dementia who is disoriented?
    It's a normal condition given his diagnosis.

These and many other diseases and conditions can have similar features to stroke. Some are even exactly the same.

The difference is in the other symptomatology typical of the particular disease and also in the lack of symptomatology. What preceded the condition (physical activity, injury, sleep, agitation) is also important.

Interesting:
Saturday night syndrome is often confused with stroke. It is a stiffening of one upper limb. This is due to prolonged pressure, for example due to overexertion. The name of the syndrome is derived from this, as men often have a woman lying on their shoulder :-)

A stroke-mimicking disease typical of older age

Older people have a number of diseases due to their age. A patient with many diagnoses is called a polymorbid patient. In addition to their underlying diagnoses, a polymorbid patient is at greater risk of developing new ones.

The body, organs and also blood vessels of old people are more worn out and weaker. Therefore, this category of patients is at a higher risk of stroke, but also of other diseases that may resemble it. Which are the most common?

Dehydration to impaired consciousness

In women, water makes up 50% of the total body weight, in men up to 60%. The greater part (up to 60%) is inside the cells (intracellular space). The remaining 40% is in their surroundings (extracellular space).

From a percentage point of view, it is clear that water is part of us. It is important for the normal functioning of the internal environment (homeostasis) and for life.

Inadequate fluid intake means a reduction in total body volume. When drinking is chronically neglected, a negative balance of water in the body occurs. This condition is called dehydration.

Dehydration occurs most often in young children during persistent diarrhea and vomiting. In the summer months, it occurs in all ages and especially in the elderly who lose their sense of thirst.

In some cases, the daily fluid intake of an old person is one cup of tea, which is very little. With such a daily intake, dehydration of the body occurs very quickly.

Table with the basic differences between dehydration and stroke:

Basic symptoms of dehydration Differences in symptoms of dehydration compared to stroke
  1. Gradual onset of weakness over days, weeks or months
  2. mild nausea may be present, with vomiting as the condition progresses
  3. pallor of the face, dryness of the skin and mucous membranes
  4. low blood pressure, resulting dizziness, flashes before the eyes
  5. general weakness of the lower and upper limbs to the same extent
  6. slurred speech (dysarthria)
  7. disorientation, confusion, aggressiveness
  8. excessive sleepiness, unconsciousness, even death
  1. sudden onset of weakness within hours to days
  2. sudden onset of nausea, straining to vomit, massive vomiting
  3. sudden pallor in the face, cold sweat
  4. low blood pressure, resulting dizziness, various visual disturbances
  5. unilateral weakness of the upper and lower limbs
  6. unintelligible speech (dysarthria, aphasia)
  7. disorientation, confusion, aggressiveness
  8. excessive sleepiness, unconsciousness, death
Treatment of dehydration Treatment of stroke
  • Adequate fluid intake (never intermittent)
  • the condition improves gradually - do not expect a rapid effect
  • call the emergency services immediately if signs of stroke are detected
  • answer the operator's questions calmly, your diagnosis may have been wrong

Febrile states, overheating

We consider a normal body temperature to be between 36.0 and 36.9 °C.

Febrile state means a febrile state. It occurs because of infection of an organ or the body (bacteria, viruses, fungi, parasites). Overheating occurs when the body is exposed to high temperatures for a long time (infections, sunburn, sunstroke).

When the body is overheated by a high temperature, fever or complete overheating, the person sweats excessively, losing water and minerals. It does not matter whether it is an infection, a burn with an inflammatory reaction of the body, or overheating in the sun. This condition is always accompanied by inappetence and vomiting.

Vomiting also causes excessive fluid loss and dehydration.

Table with the basic differences between febrilitis and stroke

Basic manifestations of febrile illness and overheating Differences in symptoms of febrile illness and overheating compared to stroke
  1. Gradual onset of weakness over days, weeks or months
  2. Increased temperature, febrility, flu-like symptoms (full nose)
  3. associated nausea, vomiting, sometimes the vomiting is massive and in the foreground
  4. red, hot face, dryness of skin and mucous membranes, excessive sweating, shivering
  5. low blood pressure, resulting dizziness, blurring before the eyes
  6. general weakness of the lower and upper limbs in equal measure
  7. headaches, muscle and joint pains throughout the body
  8. unintelligible speech only with high and prolonged fevers, dehydration
  9. disorientation, confusion, delirium
  10. excessive sleepiness even during the day (death only in severe infections - meningitis)
  1. sudden onset of weakness within hours to days
  2. body temperature is normal (febrility may be present in other, concurrent infections)
  3. sudden onset of nausea, straining to vomit, massive vomiting
  4. sudden pallor in the face, cold sweat, drops in the forehead
  5. low blood pressure, resulting dizziness, various visual disturbances
  6. unilateral weakness of the upper and lower limbs
  7. headache, in haemorrhagia also in the neck
  8. severe speech disorders - dysarthria, aphasia, stuttering
  9. disorientation, confusion, aggressiveness
  10. excessive sleepiness, unconsciousness, death
Treatment of febrile state and overheating Treatment of stroke
  • at temperatures above 38 °C, cooling the body with wraps, lukewarm showers
  • for temperatures above 38 °C, after cooling, reduce temperature with drugs (not for sunstroke)
  • bed rest, minimal physical activity
  • adequate fluid intake (never in spurts, spoonfuls if vomiting)
  • the condition improves gradually - do not expect a rapid effect
  • call the ambulance when signs of stroke are detected
  • answer the operator's questions calmly, your diagnosis may have been wrong

Dementia and disorientation

Dementia or demented state occurs mainly in older people who have Alzheimer's or Parkinson's disease. However, it can also occur at a young age.

Dementia is a weakening of the rational faculties, and the condition worsens with increasing age. Symptoms can be alleviated to some extent, but there is no cure, just as there is no cure for immortality.

Some people very often confuse dementia with a stroke, precisely because of the disorientation, lack of recognition of relatives, hallucinations and other manifestations. Even a patient who takes medication regularly may have such an attack from time to time.

Unless you are giving your relative with dementia medication and administering it directly into his mouth, he is probably not taking it himself.

It is the failure to take medication to control symptoms such as disorientation or aggression that can cause such symptoms to take us by surprise.

Table with basic differences between dementia and stroke:

Basic symptoms of dementia Differences in symptoms of dementia compared to stroke
  1. Diagnosis of a history of dementia
  2. deteriorating cognitive function over a long period of time with age
  3. disorientation gradually emerging or suddenly arising, repeatedly and in the past
  4. psychomotor restlessness, confusion, hallucinations, aggression
  5. insomnia, night waking, rages during the night
  1. there may be a history of dementia
  2. cognitive function has been fine until now
  3. sudden onset of disorientation, with lucid consciousness in the past
  4. psychomotor restlessness especially during haemorrhage, confusion, aggressiveness
  5. sleepiness predominates, progressing to impaired consciousness
Treatment of dementia Treatment of stroke
  • supervising the use of medication in such a patient
  • bed rest, minimal physical activity
  • sufficient fluid intake
  • the disease is not curable, symptoms are suppressed, it progresses with age despite treatment
  • call the ambulance service when signs of stroke are detected
  • answer the operator's questions calmly, maybe your diagnosis was wrong

A stroke mimicking disease typical of younger people

Not only in older individuals, but also in younger people, there are diseases that can falsely make us think we have had a stroke.

Most of these are not very serious illnesses, sometimes even trivial. The way some individuals experience them is catastrophic, sometimes even ridiculous.

Hyperventilation tetany gives the impression of various illnesses

Hyperventilation tetany can also be called "the disease of modern times". In the past, it also occurred. But then these people (mostly women) were called hysterical. To a large extent, this is true.

Hyperventilation tetany is primarily a psychological condition. It is always preceded by some psychological condition such as agitation, argument, anger, stress, fear, illness, vomiting, physical exertion.

The sufferer subconsciously begins to breathe more rapidly as a result of some triggering mechanism. This is called hyperventilation. As a result, he breathes out a lot of carbon dioxide that is present in the blood.

This first causes tingling in the upper limbs, possibly the mouth and head, which can cause difficulty in speaking. As the condition progresses, the lower limbs also tingle. Gradually the tingling progresses to convulsions and twisting of the arms and legs.

The patient feels faint. Very often collapses, but never unconsciousness. And worst of all, few people admit it. These people attribute gigantic proportions to their suffering.

Interesting:
Hyperventilation tetany is a frequent cause of emergency calls and ambulance call-outs. However, hyperventilation tetany never threatens the patient's life. It is a psychological condition that subsides spontaneously and without any treatment when the patient calms down and slows down his breathing. The reason why ambulances show up for these conditions is the ignorance and panic of the surrounding area.

Table with basic differences between hyperventilation and stroke:

Basic manifestations of hyperventilation Differences in symptoms of hyperventilation compared to stroke
  1. The condition is preceded by agitation, argument, stress, fear, sadness
  2. the patient is objectively breathing rapidly and shallowly
  3. subjective feeling of suffocation
  4. in a short time the patient's upper limbs begin to twitch
  5. upper limbs dialysis
  6. dizziness, feeling of fainting
  7. collapse without injury - the hysterical patient "lies down" so as not to injure himself
  8. after slowing breathing and eliminating the stress factor, the condition improves
  1. the condition is rarely preceded by agitation, stress, fear
  2. patient breathes normally
  3. no breathing difficulties
  4. patient weakens one half of the body
  5. no upper limbs dialysis
  6. dizziness, feeling faint
  7. collapse with injury, rarely with alteration of consciousness
  8. the condition does not spontaneously improve
Treatment of hyperventilation Treatment of stroke
  • Elimination of the stress factor
  • calming the patient
  • slowing breathing
  • taking medication to calm down
  • checking with a general practitioner, neurologist, and in worse cases a psychiatrist
  • call the emergency services when signs of stroke are detected
  • answer the operator's questions calmly, maybe your diagnosis was wrong

Paresthesias, headaches and dizziness are also present in spinal disorders

Who has a beautifully straight spine these days? Who has never had back pain or hand or foot tremors resulting from spinal disease or congestion? If such a person exists, I already envy them.

Everywhere in the world, people are tired and exhausted from their daily work. Most people work 5 days a week and some even on weekends. The first thing to take the brunt of this is of course the spine.

Pain in the affected part of the back is not uncommon. It occurs frequently, and in some professions it is even commonplace. If you don't have back problems yet, try thinking about your profession. Do you exert yourself? Do you lift heavy loads? Do you have a paradoxically sedentary job? Know that you are on the list.

Spinal damage doesn't have to manifest itself only in pain in a particular part. When the cervical spine is affected, there is often significant dizziness along with headaches, neck pain, nausea and vomiting. The thoracic part tends to cause tingling in one or even both upper limbs. The lumbar and sacral parts cause tingling and weakness in the lower limb.

Table with basic differences between spinal disorders and stroke:

Basic manifestations of spinal disorders Symptom differences in spinal disease compared to stroke
  1. The condition is preceded by a strained spine in various ways
  2. Head and neck pain (mild to moderate intensity)
  3. dizziness, fainting sensation, no disturbance of consciousness
  4. chest, lumbar or sacral pain
  5. tingling mostly in one upper or lower limb, more rarely in both
  6. pain radiating to the upper or lower limb
  7. pain and tingling dependent on position and movement
  8. the tingling can be relieved by massage
  1. the condition is rarely preceded by spinal congestion
  2. headache, and in the case of haemorrhage, neck pain (moderate to severe intensity)
  3. dizziness, fainting sensation, possible impairment of consciousness
  4. no thoracic, lumbar or sacral pain
  5. tremors of the upper and lower limbs on one half of the body
  6. no pain radiating to upper or lower limb
  7. tingling is constant regardless of position and movement
  8. the tingling cannot be relieved, it is still
Treatment of spinal disorders Treatment of stroke
  • Elimination of the provoking factor
  • resting mode
  • checking with a general practitioner, neurologist
  • orthopaedic aids (corsets, cervical collars)
  • use of pain killers and drugs to relax stiff muscles
  • use of drugs for dizziness and vomiting
  • massage, rehabilitation
  • injections
  • other treatment options for the condition
  • surgical solutions
  • call the emergency services when you see signs of a stroke
  • answer the operator's questions calmly, maybe your diagnosis was wrong

Headaches and migraines

In a haemorrhagic stroke, a distinctive symptom is a sudden onset headache. But this does not mean that every time we have a headache now we think we have a brain haemorrhage. It is unthinkable that every headache should be dealt with by the ambulance service and sent for a CT scan.

With headaches, we need to think a little and look for possible causes, of which there are thousands. Not every headache is automatically caused by a serious or fatal illness.

Theheadache that accompanies a stroke never develops gradually. It comes on suddenly, unexpectedly, and is often of a strong intensity. Other symptoms of stroke, such as speech impairment or unilateral weakness, are present along with the pain. There is no trauma in the patient's previous history, but in the case of chronic diseases such as migraine, the pain is different, atypical, and unexpected.

People most often call the emergency line when (table)

Causes of headaches Difference compared to stroke First aid
Headache with high blood pressure
  • the pain comes on gradually
  • builds in intensity
  • the pain is diffuse or unilateral
  • a high pressure reading is measured
  • dizziness present
  • nausea present vomiting
  • frequent palpitations
  • sometimes tingling in the head, hands
  • absence of other signs of stroke
  • use of blood pressure medication
  • taking tensiomine under the tongue
  • bed rest
  • fluid intake
headaches with low blood pressure and dehydration
  • the pain comes on gradually
  • is mild to moderate in intensity
  • the pain is diffuse, with no precise location
  • low blood pressure measured
  • dizziness present, especially when changing position
  • nausea, occasionally vomiting
  • general weakness, malaise
  • excessive sleepiness
  • pallor of the face, dryness of the skin and mucous membranes
  • absence of other symptoms
  • fluid intake
  • bed rest
headache during flu or other condition associated with increased body temperature
  • the pain comes on gradually
  • the pain is diffuse and constant
  • muscle, joint, body pain present
  • lower or normal blood pressure
  • higher body temperature
  • fluid intake
  • bed rest
  • treatment of temperature by cooling
  • antipyretics
  • antibiotics, antivirals
headaches associated with cervical spine problems
  • history of cervical spine problems
  • risky occupation
  • previous strain on the cervical spine
  • headache precedes neck pain
  • neck stiffness
  • cervical spine mobility problem
  • change in intensity depending on neck movement
  • tingling in one or both upper limbs
  • pain in one or both upper limbs
  • nausea, vomiting
  • not straining the neck
  • analgesia
  • fluid intake
  • dry heat
  • massage by a specialist
  • electrotherapy
  • treatment by a neurologist
  • surgery
headaches during stress, sleep deficit and fatigue
  • stressful periods in the antenatal period
  • chronic sleep deprivation
  • feeling of fatigue
  • general weakness
  • dizziness, fogginess in front of the eyes
  • collapse state
  • headache of mild to moderate intensity
  • nausea
  • pallor in the face
  • circles under the eyes
  • disturbances in concentration
  • lack of concentration
  • stress avoidance
  • holiday
  • getting enough sleep
  • plenty of fluids
  • balanced diet
  • relax
  • treatment of insomnia with medication
migraine headaches
  • history of migraine
  • typical onset, intensity and duration of pain
  • unilateral, throbbing, severe headache
  • increasing in intensity on movement
  • lightheadedness
  • nausea, vomiting
  • pallor in the face
  • general weakness, malaise
  • use of migraine medication
  • use of anti-vomiting drugs
  • bed rest
  • staying in a darkened room
  • finding your doctor
post-traumatic headaches
  • the condition precedes the injury
  • sometimes short-term impairment of consciousness
  • retrograde amnesia
  • pain localised to the site of injury
  • headache hours to days apart
  • nausea, vomiting
  • disorientation
  • disturbances of consciousness, unconsciousness
  • call the emergency services:
severe mechanism a load falling on the head traffic accidents falls from heights falls to depth unconsciousness after an accident impaired consciousness after an accident
  • seek help:
more trivial injuries full consciousness of the patient nausea, vomiting after trauma
  • taking medication to help with pain:
after trivial injuries only after examination in hospital after X-ray, CT scan
alcohol-related headache
  • pain comes on after taking alcohol
  • pain comes on the day after alcohol consumption
  • the pain is diffuse, possibly unilateral
  • the pain is of moderate intensity
  • nausea, vomiting
  • general weakness
  • dizziness, impaired concentration
  • bed rest
  • fluid intake
  • mineral intake
  • fresh air
  • pain relief medication
  • plenty of sleep
  • absence of alcohol

Other stroke-like illnesses

The conditions, syndromes and diseases described above are only a fraction of the many that can resemble a stroke in their symptomatology.

For the sake of frequency, only those that are the most common reasons for calling an ambulance and visiting a district doctor's office have been mentioned.

Other similar diseases include:

  • complications of diabetes - hypoglycaemia and hyperglycaemia with impaired mental status and consciousness
  • sciatic neuritis with pain and tremors in the lower limb
  • Meniere's disease characterised by intense vertigo
  • trigeminal neuritis (facial part), with facial paralysis and asymmetry
  • intoxication by drugs and medicines
  • disorientation and hallucinations due to psychiatric illness
  • other
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