Stroke Mimic – Hypoglycaemia — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

EasyCerebrovascular DiseaseStroke Mimic – HypoglycaemiaSCE Neurology

A 55-year-old man presents to the stroke unit with acute onset of right hemiparesis and aphasia 2 hours ago. His blood glucose is 2.1 mmol/L. After IV dextrose his symptoms resolve completely within 15 minutes. What does this represent?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Stroke mimic — hypoglycaemia

Hypoglycaemia is one of the most important stroke mimics, capable of producing focal neurological deficits including hemiparesis and aphasia that closely mimic acute ischaemic stroke. Blood glucose measurement is mandatory in all patients presenting with suspected stroke before initiating thrombolysis. Other common stroke mimics include seizures (with Todd's paresis), migraine with aura, functional neurological disorder, and space-occupying lesions. A: TIA resolves spontaneously without metabolic correction. C: Symptoms resolved with glucose correction. D: Todd's paresis follows a seizure. E: FND does not resolve with glucose.

Reference: RCP National Clinical Guideline for Stroke (2023); NICE NG128