emDocs - March 5, 2015 - By Jeffrey Conley.
EM Resident Physician, Albany Medical Center
Edited by Alex Koyfman MD and Stephen Alerhand MD
"Review of the main points to consider for the various presentations of stroke in the ED.Subarachnoid Hemorrhage (SAH)
– 8-20% of patients misdiagnosed on initial visit
Ischemic stroke
Uncommon stroke presentations
- Pure sensory deficit
- Pure visual loss
- Acute onset confusion, agitation, and delirium
- Dizzy (vertigo) / dysmetria
- Locked-in syndrome
- Todd’s paralysis
- Focal neurologic deficits presenting after seizure activity
- Resolves in minutes to hours (most in < 48 hours)
- Toxicology
- Complex migraine
- Hypoglycemia
- Bell’s Palsy
- Conversion disorder"
http://www.emdocs.net/unusual-stroke-presentations/