Stroke Mimics in the Pediatric Population

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Authors

  • Maria Jesús Gonzalez These authors equally contributed Emergency Department, Hospital Nacional de Niños, Dr. Carlos Sáenz Herrera, San José, Costa Rica
  • Adriana Yock-Corrales These authors equally contributed Emergency Department, Hospital Nacional de Niños, Dr. Carlos Sáenz Herrera, San José, Costa Rica

DOI:

https://doi.org/10.17140/NOJ-2-116

Keywords:

Stroke mimics; Children; Stroke.

Abstract

Pediatric stroke is a very rare condition and it is a cause of significant morbidity and
mortality. It is among the top ten causes of death in the pediatric population, and over half
of stroke survivors experience long-term disabilities. One major challenge in the diagnosis
of stroke is the fact that there are many conditions that may mimic stroke. In the pediatric
population the incidence of stroke mimic is around 79-93% of all presentations of acute focal
brain dysfunction. The most common diagnosis in children is complicated migraine, seizures
disorders, Bell’s palsy and conversion disorders. The aim of the evaluation of these conditions
is to rule out the diagnosis of acute stroke and the computed tomography (CT) is the modality
of choice as is more accessible in the Emergency Departments (ED).

References

Lynch JK. Cerebrovascular disorders in children. Current neurology and neuroscience reports. 2004; 4(2): 129-38.

Lansing AE, Max JE, Delis DC, et al. Verbal learning and memory after childhood stroke. Journal of the International Neuropsychological Society: JINS. 2004; 10(5): 742-752.

Pavlovic J, Kaufmann F, Boltshauser E, et al. Neuropsycho-logical problems after paediatric stroke: two year follow-up of Swiss children. Neuropediatrics. 2006; 37(1): 13-19. doi: 10.1055/s-2006-923932

Broderick JP, Phillips SJ, Whisnant JP, O’Fallon WM, Bergs-tralh EJ. Incidence rates of stroke in the eighties: the end of the decline in stroke? Stroke. 1989; 20(5): 577-582. doi: 10.1161/01. STR.20.5.57

Rafay MF, Pontigon AM, Chiang J, et al. Delay to diagnosis in acute pediatric arterial ischemic stroke. Stroke. 2009; 40(1): 58-64. doi: 10.1161/STROKEAHA.108.519066

Srinivasan J, Miller SP, Phan TG, Mackay MT. Delayed recognition of initial stroke in children: need for increased awareness. Pediatrics. 2009; 124(2): e227-e234. doi: 10.1542/ peds.2008-3544

Yock-Corrales A, Mackay MT, Mosley I, Maixner W, Babl FE. Acute childhood arterial ischemic and hemorrhagic stroke in the emergency department. Annals of emergency medicine. 2011; 58(2): 156-163. doi: 10.1016/j.annemergmed.2010.10.013

Gabis LV, Yangala R, Lenn NJ. Time lag to diagnosis of stroke in children. Pediatrics. 2002; 110(5): 924-928. doi: 10.1542/ peds.110.5.924

Libman RB, Wirkowski E, Alvir J, Rao TH. Conditions that mimic stroke in the emergency department. Implications for acute stroke trials. Archives of neurology. 1995; 52(11): 1119- 1122. doi: 10.1001/archneur.1995.00540350113023

Hand PJ, Kwan J, Lindley RI, Dennis MS, Wardlaw JM. Distinguishing between stroke and mimic at the bedside: the brain attack study. Stroke. 2006; 37(3):769-775. doi: 10.1161/01. STR.0000204041.13466.4c

Shellhaas RA, Smith SE, O’Tool E, Licht DJ, Ichord RN. Mimics of childhood stroke: characteristics of a prospective co-hort. Pediatrics. 2006;118(2): 704-709. doi: 10.1542/peds.2005- 2676

Mackay MT, Chua ZK, Lee M, et al. Stroke and nonstroke brain attacks in children. Neurology. 2014; 82(16): 1434-1440. doi: 10.1212/WNL.0000000000000343

Bhate S, Ganesan V. A practical approach to acute hemipa-resis in children. Developmental medicine and child neurology. 2015; 57(8): 689-697. doi: 10.1111/dmcn.12750

Hemmen TM, Meyer BC, McClean TL, Lyden PD. Identifi-cation of nonischemic stroke mimics among 411 code strokes at the University of California, San Diego, Stroke Center. J Stroke Cerebrovasc Dis. 2008; 17(1): 23-25. doi: 10.1016/j.jstrokecere-brovasdis.2007.09.008

Vroomen PC, Buddingh MK, Luijckx GJ, De Keyser J. The incidence of stroke mimics among stroke department admissions in relation to age group. J Stroke Cerebrovasc Dis. 2008; 17(6): 418-422. doi: 10.1016/j.jstrokecerebrovasdis.2008.06.007

Huff JS. Stroke mimics and chameleons. Emerg Med Clin North Am. 2002; 20(3): 583-595.

Hershey AD, Winner PK. Pediatric migraine: recognition and treatment. The Journal of the American Osteopathic Asso-ciation. 2005;105(4 Suppl 2): 2S-8S.

Levin M, Ward TN. Ophthalmoplegic migraine. Current pain and headache reports. 2004; 8(4): 306-309.

Bourgeois M, Aicardi J, Goutieres F. Alternating hemiplegia of childhood. The Journal of pediatrics. 1993; 122(5 Pt 1): 673- 679.

Singhi P, Jain V. Bell’s palsy in children. Semin Pediatr Neu-rol. 2003; 10(4) :289-297.

Bergen DC, Rayman L, Heydemann P. Bilateral Todd’s pa-ralysis after focal seizures. Epilepsia. 1992; 33(6): 1101-1105.

Kozlowska K, Palmer DM, Brown KJ, et al. Conversion disorder in children and adolescents: a disorder of cognitive control. Journal of neuropsychology. 2015; 9(1): 87-108. doi: 10.1111/jnp.12037

McGlennan C, Ganesan V. Delays in investigation and man-agement of acute arterial ischaemic stroke in children. Develop-mental medicine and child neurology. 2008; 50(7): 537-540. doi: 10.1111/j.1469-8749.2008.03012.x

Mackay MT, Wiznitzer M, Benedict SL, et al. Arterial ischemic stroke risk factors: the International Pediatric Stroke Study. Annals of neurology. 2011; 69(1): 130-140. doi: 10.1002/ ana.22224

Sridharan R. Risk factors for ischemic stroke: a case con-trol analysis. Neuroepidemiology. 1992; 11(1): 24-30. doi: 10.1159/000110903

Emam AT, Ali AM, Babikr MA. Childhood stroke in East-ern Province, KSA: pattern, risk factors, diagnosis and outcome. Acta Paediatr. 2009; 98(10): 1613-1619. doi: 10.1111/j.1651- 2227.2009.01421.x

Carlin TM, Chanmugam A. Stroke in children. Emerg Med Clin North Am. 2002; 20(3): 671-685.

Yock-Corrales A, Barnett P. The role of imaging stud-ies for evaluation of stroke in children. Pediatric emergen-cy care. 2011; 27(10): 966-974; quiz 75-77. doi: 10.1097/ PEC.0b013e318230a002

Published

2015-10-01

How to Cite

Maria Jesús Gonzalez, & Adriana Yock-Corrales. (2015). Stroke Mimics in the Pediatric Population. Neuro, 2(3), 74–78. https://doi.org/10.17140/NOJ-2-116

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Section

Articles