That depends upon the symptoms that the patient has had, plus the risk factors that the patient has for stroke, plus the expertise of the doctor we are talking about. In my opinion, anyone suspected of having a stroke or being at risk for stroke, should be seen by a neurologist, who is a specialist in brain diseases, and there are neurologists who are further specialized in stroke. And the reason this is so important is that these types of doctors can see and find things that others may not be so quick to find and then can decide what is the best course to follow. Strokes are significantly different. Seizures are abnormalities of brain electrical activity.
Strokes are abnormalities in the brain circulation.
Some patients with stroke have seizures as a secondary problem from the stroke, but the two are fundamentally different problems. As a matter of fact, there is a lot being done, not the least of which is educating the public to the fact that they need to call 911 when they suspect a stroke. In addition, in places such as Birmingham, Alabama, where I practice, we have created a regional stroke transportation emergency plan. With this system we have tied up seven counties and the ten stroke centers in those counties in a computerized online information system that allows paramedics to take stroke victims to the closest working stroke center as fast as they can. I think that very much like the heart, the tissue that is damaged is damaged forever.