Stroke symptoms are not always dramatic. A person having a stroke may still be awake, walking and talking while developing sudden numbness or weakness, especially on one side of the body, new difficulty finding words, sudden loss of balance or changes in vision.
Such stroke symptoms may be mistaken for tiredness or stress, but even apparently mild ones need immediate medical assessment. Delays can reduce access to time-sensitive treatment and increase the risk of lasting disability.
According to the Department of Statistics Malaysia (DOSM), stroke recorded without a specific ischaemic or haemorrhagic type accounted for 2.6% of medically certified deaths in 2024, making this category the sixth principal cause of death in Malaysia.
“Many people expect a stroke to look dramatic, but that is not always the case. When symptoms appear mild, many people choose to wait and see if they improve, but these delays can reduce the opportunity for timely assessment and treatment,” shares Dr Aaron Lai Kuo Huo, Consultant Emergency Physician at Sunway Medical Centre, Sunway City (SMC).
Stroke symptoms may even disappear after a few minutes, which could indicate a transient ischaemic attack (TIA), often referred to as a “mini-stroke” and a warning sign that should not be ignored. “Even if symptoms improve, urgent medical assessment is still needed,” Dr Aaron adds.
Table of Contents
Recognise Stroke Symptoms and Act Quickly With BE FAST
BE FAST remains a useful tool for recognising possible stroke symptoms:
- B – Balance: sudden loss of balance or coordination
- E – Eyes: sudden vision changes
- F – Face: facial drooping
- A – Arms: weakness or numbness in an arm
- S – Speech: difficulty speaking or understanding speech
- T – Time: seek emergency help immediately
Dr Aaron stresses that a person does not need every BE FAST symptom before seeking help. “If stroke is suspected, families should call for an ambulance and, where possible, avoid driving the patient to the hospital themselves. In an ambulance, emergency medical personnel can begin monitoring the patient on the way and alert the hospital to prepare for urgent treatment,” he explains.
While waiting, keep the person safe and comfortable, follow the dispatcher’s instructions, and avoid giving food, drinks or medications unless advised by healthcare professionals. Note when the stroke symptoms began, or when the patient was last known to be well, as this can influence treatment decisions.
Stroke Recovery Continues After Leaving Hospital
Dr Lim Swee San, Consultant Neurosurgeon & Spine Specialist at SMC, believes many people underestimate the challenges stroke survivors face after discharge.
“Families often judge recovery based on whether someone can walk again. However, stroke can also affect speech, memory, concentration and emotional wellbeing. These difficulties may not always be visible, but they can have a major impact on daily life, work and independence,” Dr Lim explains.
Rehabilitation is an integral part of stroke care, with assessment and planning beginning early and therapy introduced when the treating team considers it medically safe and appropriate. Recovery also cannot be judged by the size of the stroke alone, as even a smaller stroke affecting an area responsible for an important function can have a significant impact.
“Recovery is different for every survivor. The challenges they face, the rehabilitation they require, and the time needed to recover can vary considerably from person to person,” says Dr Lim. Goals differ too, from walking independently to improving speech or returning to work.
“Success should not be measured by comparing one survivor’s recovery with another’s. Progress is best considered against the individual’s own goals and the level of independence they are able to achieve safely and meaningfully in their daily life,” he adds.
Recovery is also about preventing future strokes. “Having a stroke once does not mean it cannot happen again. This is why follow-up care, taking medications as prescribed and managing risk factors such as high blood pressure, diabetes, high cholesterol and smoking remain important, even after leaving the hospital,” he says.
A Reminder for Every Family
This World Stroke Day, Dr Aaron and Dr Lim remind families that stroke calls for urgency when it strikes and patience in the journey that follows. Recognising stroke symptoms early gives patients the best chance of timely treatment, while follow-up care helps them work towards safety, independence and a meaningful return to daily life.
Also read: Malaysia’s First “Angels Region” Leads the Way in Stroke Care Excellence
Sources: American Stroke Association – Stroke Symptoms; Malaysia National Stroke Registry 2017–2024
