Stroke Symptoms and Warning Signs

Stroke symptoms appear suddenly, often without warning. Recognising them in yourself or someone else, and acting immediately, can mean the difference between a full recovery and permanent disability.

In Malaysia, six new cases of stroke occur every hour, with an estimated 52,000 Malaysians affected each year. Despite this, awareness of stroke warning signs in Malaysia remains low, which delays treatment at the exact moment when speed matters most.

If you suspect a stroke, do not wait. Call for emergency help immediately.

Stroke Symptoms and Signs

How to Recognise a Stroke: BEFAST

BEFAST is a simple checklist that helps you recognise the most common signs of stroke quickly, in yourself or in someone else.

stroke symptom - lose balance

B
Balance

stroke symptom - blurred vision

E
Eyes

stroke symptom - one side of face is dropping or uneven

F
Face

stroke symptom - numbness in the arm or one side of the body

A
Arm

stroke symptom - difficulty in speaking

S
Speech

stroke symptom - call ambulance and come to hospital immediately

T
Time

B - Balance

Is the person suddenly having trouble with balance or coordination? A sudden inability to stand or walk steadily, or a feeling of dizziness that comes on without warning, can be a sign of stroke.

E – Eyes

Has the person suddenly lost vision in one or both eyes, or developed blurred or double vision? Sudden visual changes, especially without pain, should never be dismissed.

F – Face

Ask the person to smile. Does one side of the face droop or feel numb? A crooked or uneven smile is one of the clearest and most recognisable signs of stroke.

A – Arm

Ask the person to raise both arms. Does one arm drift downward, or is one side noticeably weaker than the other? Sudden one-sided weakness, even if mild, is a warning sign that should not be ignored.

S – Speech

Ask the person to repeat a simple sentence. Is their speech slurred, strange, or difficult to understand? Sudden difficulty speaking or understanding speech is a key indicator of stroke.

T – Time

If you notice any of these signs, even if they seem to pass quickly, call for emergency help immediately. Note the exact time the symptoms started, as this information is critical for the treating medical team.

Important Notes:

One of the most dangerous mistakes is waiting to see if symptoms go away before seeking help. If symptoms resolve on their own within minutes to hours, this may have been a transient ischaemic attack, or TIA, often called a mini stroke. A TIA is a serious warning sign that a full stroke may follow soon after, and it requires the same urgent medical attention as an actual stroke.

Do not drive yourself or the affected person to hospital. Call for an ambulance so that trained medical personnel can begin assessment and care immediately, even before arrival at hospital.

Other Warning Signs to Watch For

While BEFAST covers the most common and recognisable signs, stroke can present in other ways as well. Watch for any of the following appearing suddenly:

A severe headache with no known cause, particularly if it is the worst headache the person has ever experienced.
Sudden confusion or difficulty understanding what is being said.
Sudden numbness in the face, arm, or leg, especially when it affects only one side of the body.
Sudden trouble walking, along with dizziness or loss of coordination.

If any of these symptoms appear suddenly, treat the situation as a medical emergency and call for help immediately, even if the person does not show every BEFAST sign.

Frequently Asked Questions

Are stroke symptoms different in women than in men?

Men and women often experience similar core stroke symptoms, such as face drooping, arm weakness, and speech difficulty. However, women may sometimes experience subtler signs such as sudden fatigue, confusion, or general weakness rather than the more classic symptoms. Because these signs can be mistaken for something less serious, they are sometimes missed or dismissed, which can delay treatment.

Can stroke symptoms come and go?

Yes. If symptoms appear and then resolve on their own within minutes to hours, this may indicate a transient ischaemic attack, or TIA. A TIA should never be ignored, even if the person seems to recover completely, as it is a strong warning sign that a full stroke could follow.

What should I do while waiting for the ambulance to arrive?

Stay with the person and keep them calm and still. Note the exact time their symptoms first appeared, as this is critical information for the treating medical team. Do not give them food, drink, or medication. If they lose consciousness, place them on their side to keep their airway clear, and continue monitoring their breathing until help arrives.

Is a sudden severe headache always a sign of stroke?

Not always, but a sudden, severe headache unlike any the person has experienced before, especially if it occurs alongside other BE FAST symptoms, should be treated seriously. This type of headache can be a warning sign of haemorrhagic stroke, where bleeding occurs in the brain, and requires immediate medical assessment.

Know the Signs, Act Without Hesitation

Recognising stroke symptoms is only the first step. Acting on them immediately, without waiting or second guessing, is what gives someone the best chance at recovery. Understanding what puts a person at higher risk of stroke can also help you stay alert to the warning signs in yourself and your loved ones.

Learn more about stroke care at our Stroke Centre in Penang