Long-term follow-up of acute functional stroke mimic in comparison to mild acute ischaemic stroke.

Each year many patients are admitted to the emergency department with a suspicion of acute ischaemic stroke (AIS). There are several conditions that can present with acute stroke-like symptoms, of which the most common are seizures, migraine and functional disorder. The latter are called functional stroke mimics (FSM). While the outcome of patients with AIS has extensively been studied, little is known about the outcome of FSM. Short-term follow-up studies in acute FSM have shown that about 80% of patients with FSM still reported symptoms after 2 months,1 but long-term follow-up studies are lacking. We therefore compared the long-term outcome in patients with FSM with patients diagnosed with mild AIS. ### Patient selection This single centre retrospective cohort study was performed in the University Medical Centre Groningen. Patients with FSM and AIS who presented between January 2016 and December 2018 were identified from a local patient registry. Inclusion criteria were: (1) suspicion of AIS by the ambulance; (2) age between 18 and 80 years; (3) mild–moderate symptoms (National Institutes of Health Stroke Scale (NIHSS) ≤10); (4) patients with AIS treated with intravenous thrombolysis; and (5) functionally independent at 3 months after admission (Modified Ranking Scale [mRS] 0–2). Final diagnosis was made by a vascular neurologist based on clinical information and imaging. Participants were approached 13–42 months after admission by mail to complete the questionnaires. Patients were also given the option to only rate their change in …