Ali et al developed a score for predicting the likelihood of a stroke mimic. This can help to identify a patient who may additional testing to exclude an alternative diagnsois. The authors are from the Partners Telestroke Network.
Patient selection: possible stroke, minimum age around 40 years
Outcome: detect a condition that might mimic a stroke
Conditions that may mimic stroke include: seizure, migraine, encephalopathy, and conversion disorder
Parameters:
(1) age in years
(2) atrial fibrillation
(3) hypertension
(4) seizure
(5) facial weakness
(6) NIHSS
|
Parameter |
Finding |
Points |
|
age in years |
|
0.2 * <years> |
|
atrial fibrillation |
absent |
0 |
|
|
present |
6 |
|
hypertension |
absent |
0 |
|
|
present |
3 |
|
seizure |
absent |
0 |
|
|
present |
-6 |
|
facial weakness |
absent |
0 |
|
|
present |
9 |
|
NIHSS |
<= 14 |
0 |
|
|
> 14 |
5 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 2 (with an age of 40 years)
• maximum score: around 40
• The higher the score the less likely that the patient has a condition that mimics a stroke.
probability of a stroke mimic =
= (0.04548 * ((points)^2)) - (3.921 * (points)) + 85.01
Performance:
• The area under the ROC curve is around 0.75.
Specialty: Neurology
