Stroke Mimics

REGULATORY CLARIFICATION:

This app is NOT a regulated medical device.
It is a clinical decision-support and educational
reference tool for qualified healthcare professionals.

Evidence base (12 cited references):
- NICE NG128 (2019, updated 2024) -- Stroke and TIA:
diagnosis and initial management
- RCP National Clinical Guideline for Stroke 2023
- ESO Guidelines for Management of Ischaemic Stroke
2021 (Eur Stroke J 2021; 6:I-LXII)
- NICE CG137 (2012, updated 2022) -- Epilepsies:
diagnosis and management
- Tsivgoulis G et al. -- SITS-ISTR registry, safety
of thrombolysis in stroke mimics
(Stroke 2011; 42:1589-1593)
- Tsivgoulis G et al. -- Stroke mimics frequency
(J Neurol Neurosurg Psychiatry 2015; 86:451-457)
- Zinkstok SM et al. -- Thrombolysis in stroke mimics
(Stroke 2013; 44:1090-1096)
- Chalela JA et al. -- MRI DWI diagnostic accuracy
(Lancet 2007; 369:293-298)
- Kapur J et al. -- ESETT trial
(N Engl J Med 2019; 381:2103-2113)
- Stone J, Carson A, Sharpe M -- FND
(Pract Neurol 2012; 12:76-82)
- Fugate JE, Rabinstein AA -- PRES review
(Lancet Neurol 2015; 14:914-925)

App features:
- 8-step systematic mimic exclusion pathway
- Live glucose assessment calculator (BM entry,
instant colour-coded IVT recommendation)
- 8-category mimic accordion (tap to expand each
category with clinical features and IVT guidance)
- 7-tab specific management interface (Seizure,
Hypoglycaemia, Migraine, FND, Septic, Structural,
Metabolic)
- Three-tier IVT risk stratification (Give / Consider
/ Withhold) with clinical criteria for each
- IVT decision checklist (5 items)
- NIHSS stroke vs mimic pattern comparison
- MRI DWI interpretation table (5 scenarios)
- CT mimic findings table with IVT decisions
- Seizure drug dosing: lorazepam, levetiracetam,
valproate (ESETT trial evidence)
- Disposition criteria (admit vs discharge)
- Safety-netting checklist with DVLA advice
- Font size A- / A+ adjustment
- 12-citation references page, 10 inline badges
- No login required
- No patient data stored or transmitted
- Regulated medical device: No

Developer: Dr Atif Elnil MBBS MRCP Neurology Department St George's London UK