Background The rate of intravenous tissue plasminogen activator(IVtPA)administered to stroke mimics(SM)occurs in 24%-44%of telestroke series.Methods We reviewed 270 suspected acute ischaemic stroke(AIS)patients who we...Background The rate of intravenous tissue plasminogen activator(IVtPA)administered to stroke mimics(SM)occurs in 24%-44%of telestroke series.Methods We reviewed 270 suspected acute ischaemic stroke(AIS)patients who were evaluated by telestroke and received IVtPA from 1 July 2016 to 30 September 2017 at our academic comprehensive stroke centre.Results Among 270 AIS patients who received IVtPA via telestroke,64(23.7%)were diagnosed with SM.Compared with patients who had a stroke,the SM group was younger(mean age 56.4 vs 68.2,p<0.0001),more likely to be female(60.9%vs 45.6%,p=0.0324)and had longer door-to needle times(85.3 vs 69.9,p=0.0008).The most common SM diagnoses were migraine 26(40.6%),conversion disorder 12(18.8%),encephalopathy 7(10.9%)and unmasking(9.4%).Among the SM,migraine and conversion disorder were younger compared with the other subgroups(p<0.001).Functional exam elements were noted more frequently in conversion disorder(66.7%)and migraine(34.6%),but rare in other diagnoses(p=0.006).Among the SM,23(35.9%)had a history of a prior similar episodes,and 15(23.4%)had a history of more than 5 spells.Conclusions In our telestroke programme,23.7%of those administered thrombolysis had a final diagnosis of SM.展开更多
文摘Background The rate of intravenous tissue plasminogen activator(IVtPA)administered to stroke mimics(SM)occurs in 24%-44%of telestroke series.Methods We reviewed 270 suspected acute ischaemic stroke(AIS)patients who were evaluated by telestroke and received IVtPA from 1 July 2016 to 30 September 2017 at our academic comprehensive stroke centre.Results Among 270 AIS patients who received IVtPA via telestroke,64(23.7%)were diagnosed with SM.Compared with patients who had a stroke,the SM group was younger(mean age 56.4 vs 68.2,p<0.0001),more likely to be female(60.9%vs 45.6%,p=0.0324)and had longer door-to needle times(85.3 vs 69.9,p=0.0008).The most common SM diagnoses were migraine 26(40.6%),conversion disorder 12(18.8%),encephalopathy 7(10.9%)and unmasking(9.4%).Among the SM,migraine and conversion disorder were younger compared with the other subgroups(p<0.001).Functional exam elements were noted more frequently in conversion disorder(66.7%)and migraine(34.6%),but rare in other diagnoses(p=0.006).Among the SM,23(35.9%)had a history of a prior similar episodes,and 15(23.4%)had a history of more than 5 spells.Conclusions In our telestroke programme,23.7%of those administered thrombolysis had a final diagnosis of SM.
