Summary: This article provides the basis for a quick assessment of the likelihood of a stoke mimic, and therefore infers the likelihood of stroke. The score is not perfect. The presence of isolated sensory deficit at predicting a stroke mimic is interesting. The article does not state whether this finding is due to the presence of Bell’s palsies.
Patients: 784 patients (41% stroke mimics) in the emergency department who received MRI
Examiners: each patient was examined by both a neurology house staff and a vascular neurologist
Examination method:
FABS (6 variables with 1 point for each variable present):
- absence of Facial droop,
- negative history of Atrial fibrillation,
- Age <50 years, systolic
- Blood pressure <150 mm Hg at presentation,
- history of Seizures, and
- isolated Sensory symptoms without weakness at presentation.
Reference standard: assessment by stroke team after MRI
Findings:
Accuracy for identifying |
Predictive value for |
|||
Finding | Sensitivity | Specificity | Positive predictive value | Negative predictive value |
Absence of a-fib |
96 |
17 |
45 |
86 |
Presence of isolated sensory deficit |
15 |
97 |
77 |
62 |
FABS≥3 |
90 |
91 |
87 |
93 |
Citation
Goyal N, Tsivgoulis G, Male S, Metter EJ, Iftikhar S, Kerro A, Chang JJ, Frey JL, Triantafyllou S, Papadimitropoulos G, Abedi V, Alexandrov AW, Alexandrov AV, & Zand R (2016). FABS: An Intuitive Tool for Screening of Stroke Mimics in the Emergency Department. Stroke; a journal of cerebral circulation, 47 (9), 2216-20 PMID: 27491733
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