# Hypokalemia Masquerading as Large Vessel Occlusion Stroke: A Case Report

## TL;DR

A patient's hypokalemia was mistaken for a stroke, but symptoms improved after treating the electrolyte imbalance.

## Contribution

This case highlights hypokalemia as a stroke mimic and emphasizes the need for clinicians to consider such mimics.

## Key findings

- Neuroimaging failed to show acute stroke despite stroke-like symptoms.
- Severe hypokalemia was identified as the underlying cause.
- Symptoms resolved rapidly after electrolyte repletion.

## Abstract

This report describes a case of hypokalemia-induced hemiplegia and altered mental status masquerading as an acute large vessel occlusion (LVO) stroke, and provides a brief discussion of stroke mimics. An air ambulance was dispatched to rendezvous with a ground emergency medical services (EMS) crew to manage a 75-year-old female patient with altered mental status and left-sided weakness. The patient was transported to a comprehensive stroke center (CSC), where neuroimaging failed to demonstrate evidence for acute stroke, although the patient was found to have severe hypokalemia. The patient’s symptoms rapidly resolved following electrolyte repletion. This report highlights that prehospital and emergency department clinicians should have a familiarity with and a high index of suspicion for common stroke mimics.