differential diagnosis
Last reviewed 01/2018
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.