Ischemic stroke differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S [2]

Overview

Neurosyphilis can present with strokes and must be differentiated from other causes.

Diseases	Laboratory Findings				Physical Examination				History and Symptoms				Other Findings
Diseases	CBC	CT scan	BMP	CSF changes	Motor strength	Sensory deficit	Reflexes	Gait	Headache	LOC	Motor weakness	Abnormal sensations	Other Findings
Brain tumour^[1]					↓	+			+
Hemorrhagic stroke						+			+	+
Subdural hemorrhage									+
Neurosyphilis^[2]^[3]			+		↓
Complex or atypical migraine	↑								+
Conversion disorder		↓			↓					+
Electrolyte disturbance
Intracranial neoplasm
Meningitis or encephalitis					↓				+
Multiple sclerosis exacerbation					↓
Seizure					↓					+
Hypoglycemia or hyperglycemia										+

↑ Morgenstern LB, Frankowski RF (1999). "Brain tumor masquerading as stroke". J Neurooncol. 44 (1): 47–52. PMID 10582668.
↑ Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.
↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.