Abstract
Background Obstructive sleep apnoea (OSA) is considered as a risk factor for stroke and can produce global neurological symptoms. It is not usually considered within the aetiology of focal neurological symptoms or in the differential of stroke-like presentations.
This is a case series which highlights that it is crucial for neurologists to be familiar with the identification of OSA, early in its presentation, to provide optimal care for their patients. OSA can manifest as a stroke mimic which is not being recognised in routine clinical practice.
Methodology This series explored patients, within a large stroke centre/tertiary care hospital in NSW, and identified 7 clinical cases with undiagnosed OSA who presented as a stroke mimic.
Findings All cases presented with transient neurological symptoms, labelled as transient ischemic attacks (TIAs), proven without evidence of an acute stroke, based on extensive work up. They were diagnosed with OSA and achieved symptomatic relief with continuous positive air pressure (CPAP) therapy.
This series provides strong evidence for the need to consider early screening and treatment of OSA, to obviate the risk of further vascular events, with early referral for diagnostic polysomnography (PSG).
Conclusion This report represents the first case series to report OSA presenting as a stroke mimic. OSA should be considered, as a stroke risk factor, once all other aetiologies have been eliminated. Early recognition and effective treatment with CPAP therapy will reduce recurrent presentations and help with complete symptomatic cessation of transient neurological manifestations.
