Conditions That Mimic a Stroke: Symptoms, Causes, and More

AWhen someone shows sudden symptoms like slurred speech, facial drooping, or numbness, the first thought is often stroke. And rightly so—strokes are medical emergencies that require immediate attention. However, several other conditions can mimic the signs of a stroke, leading to confusion for patients and medical professionals alike.

Understanding these look-alike conditions can help you recognize when symptoms might indicate something else. Here’s a closer look at eight conditions that can sometimes be mistaken for a stroke and how they differ.

1. Seizures

Seizures occur when there is abnormal electrical activity in the brain. Depending on the type of seizure, the symptoms can range from minor muscle twitching to full-body convulsions. Some types of seizures, particularly focal or partial seizures, can mimic stroke-like symptoms, including sudden weakness, confusion, or speech difficulties.

Unlike a stroke, which involves a disruption of blood flow to the brain, seizures are caused by abnormal brain electrical activity. In some cases, a seizure can cause temporary paralysis or weakness on one side of the body, known as "Todd’s paralysis," which may resemble a stroke. If a seizure is suspected, a doctor will often recommend an electroencephalogram (EEG) to monitor brain activity and help distinguish it from a stroke.

Key Differences:

• Seizures often involve jerking movements or loss of consciousness, which are not typical of a stroke.
• Postictal weakness, or Todd’s paralysis, usually resolves within hours to days, while stroke symptoms persist without treatment.

2. Migraines

Migraines are intense headaches often accompanied by nausea, vomiting, and sensitivity to light and sound. However, some people with migraines may experience symptoms that are similar to a stroke, such as temporary vision changes (like blind spots or tunnel vision), weakness in the arms or legs, or difficulty speaking. This is known as a "migraine with aura," which is a visual or sensory disturbance that occurs before or during the migraine.

The main difference between a stroke and a migraine is the duration and the cause. While stroke symptoms are typically sudden and persist, migraine symptoms usually resolve within a few hours. If someone has a history of migraines, but suddenly experiences a different or more severe type of attack, it’s crucial to seek medical attention to rule out stroke.

Key Differences:

• Migraine symptoms usually develop gradually over minutes to an hour, while stroke symptoms tend to present suddenly.
• Migraine auras often involve shimmering lights, zigzag patterns, or blind spots in vision.

3. High Blood Pressure (Hypertension)

Chronic high blood pressure can have a significant impact on your cardiovascular health, increasing your risk of a stroke. However, extremely high blood pressure can sometimes mimic the symptoms of a stroke. When blood pressure spikes dangerously high, it can lead to sudden headaches, confusion, blurry vision, and even weakness or numbness on one side of the body.

While these symptoms can resemble a stroke, hypertension-related issues typically don’t cause permanent damage like a stroke does. However, a hypertensive crisis requires immediate medical intervention to avoid long-term complications like organ damage or a stroke.

Key Differences:

• Hypertension-related symptoms often come with extremely high blood pressure readings (e.g., 180/120 mm Hg or higher).
• Unlike strokes, these symptoms usually improve once blood pressure is managed.

4. Brain Tumor

A brain tumor, whether malignant or benign, can put pressure on various parts of the brain and cause a variety of neurological symptoms. Depending on the location of the tumor, it can lead to weakness, vision problems, difficulty speaking, or balance issues—symptoms that are very similar to a stroke.

The key difference between a stroke and a brain tumor is that stroke symptoms present suddenly, whereas brain tumor symptoms may develop gradually over time. Imaging tests, such as an MRI or CT scan, are crucial in distinguishing between a stroke and a brain tumor. If a brain tumor is suspected, early detection and treatment are essential for improving outcomes.

Key Differences:

• Brain tumor symptoms tend to develop slowly over weeks or months, unlike the rapid onset seen in strokes.
• Persistent headaches, seizures, or personality changes are more characteristic of a tumor.

 5. Bell’s Palsy

Bell’s palsy is a condition that causes sudden, temporary paralysis or weakness of the muscles on one side of the face. It occurs when the facial nerve becomes inflamed, leading to a drooping eyelid, a drooping mouth, or difficulty smiling on one side of the face. While Bell’s palsy affects only the facial muscles, it can be mistaken for a stroke, especially if someone is experiencing other symptoms like numbness or tingling in the face.

Unlike a stroke, which affects both the face and the body, Bell’s palsy typically affects only facial muscles. Bell’s palsy symptoms usually improve within weeks to months, and treatment options, such as steroids, can help reduce inflammation and promote recovery.

Key Differences:

• Bell’s palsy affects only facial muscles, whereas strokes typically involve other parts of the body, such as the arm or leg.
• People with Bell's palsy usually cannot raise their eyebrow on the affected side, which stroke patients sometimes can do.

6. Multiple Sclerosis (MS)

Multiple sclerosis is a chronic autoimmune disease that affects the central nervous system. It causes the immune system to attack the protective covering of nerve fibers, leading to symptoms such as weakness, numbness, vision problems, and difficulty with coordination and balance. These symptoms can mimic those of a stroke, especially if they occur suddenly or in a specific part of the body.

However, unlike a stroke, MS symptoms tend to develop and worsen over time. MS is diagnosed through a combination of neurological exams, MRIs, and tests to check for the characteristic lesions in the brain and spinal cord. MS is a lifelong condition, but with the right treatment, many people can manage the symptoms and often maintain a good quality of life.

Key Differences:

• MS symptoms often resolve partially or fully over time but may recur, unlike stroke symptoms, which persist or worsen without treatment.
• MS episodes are typically accompanied by a history of prior neurological events.

7. Sepsis

Sepsis, a life-threatening response to infection, can affect the brain and cause symptoms like confusion, slurred speech, and weakness. These symptoms are sometimes mistaken for a stroke.

Key Differences:

• Sepsis is usually accompanied by signs of infection, such as fever, rapid heart rate, or difficulty breathing.
• Unlike strokes, sepsis-related symptoms tend to fluctuate rather than remain static.

If sepsis is suspected, it requires urgent treatment to address the underlying infection and prevent complications.

8. Conversion Disorder

Conversion disorder, also known as functional neurological symptom disorder, is a condition in which a person experiences neurological symptoms, such as paralysis, speech difficulties, or loss of coordination, without an underlying medical cause. This disorder often occurs in response to stress or trauma and can present with symptoms that mimic a stroke. It can also occur due to a remote traumatic or stressful event, such as a history of abuse as a child or an emotionally traumatic event in the past.

Unlike a stroke, conversion disorder does not involve any physical damage to the brain or nervous system. The symptoms are real, but they are caused by psychological factors rather than a medical condition. Diagnosis is made through a process of elimination, where doctors rule out other potential causes, including stroke, before concluding that conversion disorder is the likely cause.

Key Differences:

• Conversion disorder symptoms often don’t follow typical anatomical patterns of nerve or brain function.
• Stressful events or psychological distress often precede the onset of symptoms.

When in Doubt, Seek Immediate Medical Attention

With so many conditions that mimic a stroke, it’s essential to treat any sudden neurological symptoms as a medical emergency. Time is critical in diagnosing and treating strokes, so calling 911 and getting to a hospital quickly is always the safest course of action.

Doctors may use a combination of physical exams, blood tests, imaging (such as CT scans or MRIs), and other diagnostic tools to determine the cause of symptoms.

How CHI Memorial Can Help

At CHI Memorial, our team of specialists is trained to recognize and treat strokes and stroke mimics. Our advanced imaging technology and experienced medical staff ensure you or your loved one receives an accurate diagnosis and prompt care.

If you’re ever unsure whether symptoms are due to a stroke or another condition, don’t wait—seek help immediately. Your health and peace of mind are our priorities.

Learn More About Stroke Care