Functional stroke mimics are an important subgroup admitted to acute stroke services and have a distinct demographic and clinical profile. Their outcomes are poorly monitored. Services should be developed to better diagnose and manage these patients.

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AimTo establish whether the groups of patients with conditions that mimic Stroke display certain characteristics which differentiate them from patients with true Stroke.MethodsAll admissions to King's College Hospital's Hyper–Acute Stroke Unit (HASU) over 12 months were reviewed using SINAP data. Subgroups of functional stroke mimics (FSM) and medical mimics (MM) were identified through consensus between experts. Statistical analysis comparing these subgroups to Stroke admissions was performed using Chi2, Kruskal–Wallis and Mann–Whitney methods.ResultsFSM patients (N=98) were younger (mean age 49, p<0.001) and mostly females (63.27%, p=0.003). They had the shortest stay on HASU and were more likely to have had MRI during admission. Compared to MM (N=198), FSM were more likely to have had history of Asthma, Back Pain, Migraine or Depression (p=0.001). FSM presented later compared to Strokes (N=904) (latency FSM 4.57 hrs vs. Stroke 2.17 hrs, p<0.001) and were less likely to present with cortical features (Visual disturbances, Dysphasia or Neglect, p<0.001) or facial weakness or numbness. MM were much more likely to present with altered consciousness (MM 15.34% vs. FSM 4.08% vs. Stroke 1.99%, p<0.001).ConclusionBoth functional and medical stroke mimics appear to have distinct features that could aid the diagnostic process.

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