When considering a discussion regarding end of life care in the context of a stroke, it is important to ensure that the diagnosis is correct and patient preferences have been considered with respect to any potential appropriate treatments. In particular, whether an alternative reversible diagnosis such as non-convulsive status epilepticus or other metabolic disturbances (e.g. hypoglycaemia) could be attributing to the patient’s status. Once alternative causes have been ruled out, and the diagnosis is felt to be clinically a severe stroke, then discussion on patient and/or family preferences on possible treatment approaches should be explored
Key points to remember:
- It is crucial that the correct diagnosis is made before initiating end-of-life care
- Consider rare mimics such as non-convulsive status epilepticus
- If the brain imaging is normal it is particularly important to consider stroke mimics, though clearly normal stroke imaging is still compatible with a severe ischaemic stroke
- Consider all possible treatment options before making a decision to initiate end-of-life care
Page last reviewed: 16 Jan 2023
