Parkinsonism or other movement disorders presenting as stroke mimics

Cheng Yang Hsieh, Chih Hung Chen, Sheng Feng Sung, Wen Juh Hwang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. stroke mimic. The purpose of the present study was to explore the clinical features and consequences of patients with parkinsonism or other movement disorders presenting as stroke mimics with activation of a stroke code. Methods: In this retrospective case-series study, we reviewed the charts and stroke code registry data in two stroke centers with high volume of stroke codes and thrombolytic therapy in the Southern Taiwan. Results: We found seven male patients (67.0 ± 12.8 years old): one with focal myoclonus, one with focal dystonia, and the other five with parkinsonism. The chief problems for emergency department visit included acute consciousness disturbance in one patient and motor weakness in other six patients. Five of the six patients with motor weakness complained unilateral symptoms. Six patients were evaluated by neurology residents (five by second-year residents, one by a third-year resident) and one by a board-certified neurologist, while a misdiagnosis of a stroke was made in three patients. All patients experienced neurological improvement when follow-up. One patient who received intravenous thrombolytic therapy had no intracranial hemorrhagic complications. Conclusion: Although rare, parkinsonism or other movement disorders may present as a stroke mimic with activation of a stroke code. Consulting neurologists should clarify the etiology for those patients with acute consciousness disturbance or motor weakness and avoid unnecessary thrombolysis.

Original languageEnglish
Pages (from-to)124-128
Number of pages5
JournalActa Neurologica Taiwanica
Volume25
Issue number4
Publication statusPublished - 2016 Jan 1

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Movement Disorders
Parkinsonian Disorders
Stroke
Consciousness
Thrombolytic Therapy
Diagnostic Errors
Hospital Emergency Service
Dystonic Disorders
Myoclonus
Neurology
Taiwan
Stroke Volume
Registries

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Hsieh, Cheng Yang ; Chen, Chih Hung ; Sung, Sheng Feng ; Hwang, Wen Juh. / Parkinsonism or other movement disorders presenting as stroke mimics. In: Acta Neurologica Taiwanica. 2016 ; Vol. 25, No. 4. pp. 124-128.
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abstract = "Purpose: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. stroke mimic. The purpose of the present study was to explore the clinical features and consequences of patients with parkinsonism or other movement disorders presenting as stroke mimics with activation of a stroke code. Methods: In this retrospective case-series study, we reviewed the charts and stroke code registry data in two stroke centers with high volume of stroke codes and thrombolytic therapy in the Southern Taiwan. Results: We found seven male patients (67.0 ± 12.8 years old): one with focal myoclonus, one with focal dystonia, and the other five with parkinsonism. The chief problems for emergency department visit included acute consciousness disturbance in one patient and motor weakness in other six patients. Five of the six patients with motor weakness complained unilateral symptoms. Six patients were evaluated by neurology residents (five by second-year residents, one by a third-year resident) and one by a board-certified neurologist, while a misdiagnosis of a stroke was made in three patients. All patients experienced neurological improvement when follow-up. One patient who received intravenous thrombolytic therapy had no intracranial hemorrhagic complications. Conclusion: Although rare, parkinsonism or other movement disorders may present as a stroke mimic with activation of a stroke code. Consulting neurologists should clarify the etiology for those patients with acute consciousness disturbance or motor weakness and avoid unnecessary thrombolysis.",
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Hsieh, CY, Chen, CH, Sung, SF & Hwang, WJ 2016, 'Parkinsonism or other movement disorders presenting as stroke mimics', Acta Neurologica Taiwanica, vol. 25, no. 4, pp. 124-128.

Parkinsonism or other movement disorders presenting as stroke mimics. / Hsieh, Cheng Yang; Chen, Chih Hung; Sung, Sheng Feng; Hwang, Wen Juh.

In: Acta Neurologica Taiwanica, Vol. 25, No. 4, 01.01.2016, p. 124-128.

Research output: Contribution to journalArticle

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AU - Hsieh, Cheng Yang

AU - Chen, Chih Hung

AU - Sung, Sheng Feng

AU - Hwang, Wen Juh

PY - 2016/1/1

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N2 - Purpose: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. stroke mimic. The purpose of the present study was to explore the clinical features and consequences of patients with parkinsonism or other movement disorders presenting as stroke mimics with activation of a stroke code. Methods: In this retrospective case-series study, we reviewed the charts and stroke code registry data in two stroke centers with high volume of stroke codes and thrombolytic therapy in the Southern Taiwan. Results: We found seven male patients (67.0 ± 12.8 years old): one with focal myoclonus, one with focal dystonia, and the other five with parkinsonism. The chief problems for emergency department visit included acute consciousness disturbance in one patient and motor weakness in other six patients. Five of the six patients with motor weakness complained unilateral symptoms. Six patients were evaluated by neurology residents (five by second-year residents, one by a third-year resident) and one by a board-certified neurologist, while a misdiagnosis of a stroke was made in three patients. All patients experienced neurological improvement when follow-up. One patient who received intravenous thrombolytic therapy had no intracranial hemorrhagic complications. Conclusion: Although rare, parkinsonism or other movement disorders may present as a stroke mimic with activation of a stroke code. Consulting neurologists should clarify the etiology for those patients with acute consciousness disturbance or motor weakness and avoid unnecessary thrombolysis.

AB - Purpose: Patients with parkinsonism or other movement disorders may visit the emergency department due to acute deterioration of neurological status or consciousness disturbance. Under such circumstances, patients may be misdiagnosed as having a hyperacute stroke, i.e. stroke mimic. The purpose of the present study was to explore the clinical features and consequences of patients with parkinsonism or other movement disorders presenting as stroke mimics with activation of a stroke code. Methods: In this retrospective case-series study, we reviewed the charts and stroke code registry data in two stroke centers with high volume of stroke codes and thrombolytic therapy in the Southern Taiwan. Results: We found seven male patients (67.0 ± 12.8 years old): one with focal myoclonus, one with focal dystonia, and the other five with parkinsonism. The chief problems for emergency department visit included acute consciousness disturbance in one patient and motor weakness in other six patients. Five of the six patients with motor weakness complained unilateral symptoms. Six patients were evaluated by neurology residents (five by second-year residents, one by a third-year resident) and one by a board-certified neurologist, while a misdiagnosis of a stroke was made in three patients. All patients experienced neurological improvement when follow-up. One patient who received intravenous thrombolytic therapy had no intracranial hemorrhagic complications. Conclusion: Although rare, parkinsonism or other movement disorders may present as a stroke mimic with activation of a stroke code. Consulting neurologists should clarify the etiology for those patients with acute consciousness disturbance or motor weakness and avoid unnecessary thrombolysis.

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