ABSTRACT NUMBER: ESOC2026A1961 TRANSIENT FOCAL NEUROLOGICAL EVENTS EVALUATED IN A TIA CLINIC: DIFFERENTIATING SUSPECTED TIA FROM TIA MIMICS

Abstract Background and aims More often than stroke, TIAs often pose us with a greater diagnostic challenge. Transient symptoms, heavy reliance on recall of events and absent symptoms at presentation, add to the dilemma. We aimed to look at the neurological causes of TIA mimics presenting to the TIA clinic of a comprehensive stroke centre. Methods We retrospectively analysed 1975 patients referred to the TIA clinic over a two-year period in the TIA Clinic and studied the neurological causes of TIA Mimics. Results Of the 1975 patients presenting to the TIA clinic, 1160 were TIA mimics, in whom stroke or TIA were excluded, 27.7% (n=321) were migraine. Syncope/ vasovagal episode related (13.6%, n=158), vestibular and labyrinthine (6.1%, n=71), functional neurological disorders like psychogenic or conversion disorder or factitious disorders (4.2%, n=49) were the other major diagnoses. Other causes were decompensation of previous stroke (n=30) neuropathies including nerve entrapments (n=27), transient global amnesia (n=23), seizure (n=23), ocular causes like vitreous and retinal detachment, glaucoma, computer vision syndrome (n=22), Unexplained transient symptoms like transient confusion(n=20), metabolic disturbances like hypoglycemias, drug toxicity, tumours (n=7), demyelinating disorders, and Bell’s palsy etc. Conclusions Good clinical judgement with accurate history taking and examination is essential to ensure a proper diagnosis (as imaging cannot definitely rule out stroke) and avoidance of improper prescribing of antiplatelet medication, apart from the serious impact on the patient and the family from a wrong diagnosis. Multi-specialty approach with prompt signposting to the relevant specialties can lead to effective treatment strategies. Conflict of interest Kamya Rangarajan: Nothing to disclose, Dr Senthil Raghunathan: Nothing to disclose, Dr Sunil Munshi: Nothing to disclose, Dr Sharvari Inamdar: Nothing to disclose Dr Usman Ali : Nothing to disclose