5 Health Conditions That Can Cause Stroke-Like Symptoms

5 common stroke mimics

1. Seizure

With a seizure, nerve cells in the brain send out sudden, excessive, uncontrolled electrical signals, causing changes in awareness, thinking, behavior or body movement. There are two types of seizures: A generalized seizure can affect both sides of the brain, and what’s known as a focal seizure affects one side of the brain.

Like a stroke, a seizure “can cause weakness, numbness, gaze deviation and trouble with speech,” Gulati says. But unlike a stroke, “seizures can cause jerking or shaking of the body before or after these symptoms.”

2. Brain tumor

A brain tumor is an abnormal mass of tissue in which cells grow and multiply uncontrollably. Brain tumors can be benign (noncancerous) or malignant (meaning cancerous). Either way, they can mimic a stroke — especially gliomas, the most prevalent type of malignant brain tumor in adults, and meningiomas, the most common benign brain tumor.

Depending on the location of the tumor, symptoms may include severe headaches, difficulty thinking or speaking, vision loss, and nausea or vomiting.

One tip-off you’re experiencing this particular type of stroke mimic and not an actual stroke? “Brain tumors grow over time,” Zhang says. “You can have progressive weakness on one side or the other, depending on whether the tumor is on the right side of the brain or the left.” A stroke, on the other hand, “happens suddenly — like a heart attack.”

3. Migraine

Migraines are characterized by pounding pain on one side of your head, which may seem very stroke-like, especially if it’s your first migraine. One clue it isn’t a stroke: Migraines tend to send advance notice of their impending arrival. Around 24 hours before getting a migraine, for instance, you may experience food cravings, uncontrollable yawning or fluid retention; or you may see what look like heat waves, if not flashing or bright lights right before a migraine (what’s known as an aura).

A “complicated migraine,” on the other hand, is trickier to distinguish from a stroke. The headache is accompanied by significant neurological symptoms such as paralysis on one side of the body or an inability to speak or understand speech. “When someone has a complicated migraine, they start out with a headache, but that gradually evolves to weakness or numbness on one side of the body, very much similar to a stroke,” Zhang says.

While strokes are sudden, a complicated migraine “is what we call a gradual onset with a slow march,” Zhang says. “If a patient has experienced this before, and it’s similar to their usual migraines, then we know it’s a migraine and not an acute stroke.” 

4. High or low blood sugar

Someone with diabetes who’s experiencing an episode of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) might very well appear to be having a stroke.

If your blood sugar is low, you may feel shaky, jittery, dizzy, lightheaded or confused; if it’s very low, you could lose consciousness or have a seizure. If your blood sugar is high, you may feel tired, weak, headachy; your vision may become blurred. How to know if either of these is a stroke versus a stroke mimic? The answer is in the blood work. “The symptoms get better with resolution of high or low blood glucose,” Gulati says. Not so with a stroke.

5. Bell’s palsy

With Bell’s palsy — the most common cause of temporary facial paralysis — one of the nerves that control muscles in your face becomes injured or stops working the way it should and as a result one side of your face suddenly becomes weak or paralyzed. Similar to other stroke mimics, Bell’s palsy comes on slowly, over hours or days. Other symptoms: a drooping eyebrow and mouth; difficulty closing an eye; drooling from one side of the face.

One telling clue it’s Bell’s palsy and not a stroke can be found in the forehead, of all places. “Bell’s palsy involves the whole face, including the forehead,” says Gulati. “Facial weakness caused by stroke usually involves the lower face and spares the forehead.”