Post-ictal weakness versus stroke — DipIMC MCQ

Correct answer: C — Treat as possible stroke and transport to a hyperacute stroke service

Option C is correct because Post-ictal weakness can mimic stroke, but persistent focal deficit still requires urgent stroke pathway assessment. Option B is less appropriate because watchful waiting risks deterioration or delays definitive care; option A is less appropriate because the clinical risk exceeds that destination or timeframe. Option E is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option D is less appropriate because analgesia is important but not sufficient as the primary intervention. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines; NICE Stroke guidance