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Differential diagnosis

Authoring team

The differential diagnosis of a TIA includes:

  • migraine:
    • one third of TIA's are accompanied by headache
    • migraine is associated with positive symptoms and frequently involve the visual system
    • symptoms of TIA arise swiftly, affect several parts of the body simultaneously, and peak in seconds to minutes

  • epilepsy:
    • focal epileptic seizures usually cause 'positive' phenomena e.g. rapid march of symptoms up the arm or leg
    • confusion between focal motor seizures and TIA's tend to arise when post-ictal weakness (Todd's paresis) is emphasised rather than jerking, or the seizure is an inhibitory type

  • structural brain lesions:
    • tumours
    • chronic subdural haematomas
    • vascular malformation

  • other non-vascular causes:
    • multiple sclerosis
    • Meniere's disease
    • hypoglycaemia
    • hysteria (1,2)

  • in patients with transient monocular symptoms:
    • giant cell arteritis
    • malignant hypertension
    • glaucoma
    • papilloedema

  • transient global amnesia (1)

Reference:

  • (1) Solenski NJ. Transient Ischemic Attacks: Part I. Diagnosis and Evaluation. AAFP 2004;69:1665-74,1679 2
  • (2) Edlow JE. Current Controversies in the Management of TIA. ACEP Scientific Assembly.

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