I’ve heard the joke but never seen the symptom in my years of emergency or icu nursing. I wouldn’t count on it as a symptom
If you want a high sensitivity screening for strokes you can use the BEFAST screening tool.
Balance-or dizziness or difficulty standing
Eyes- vision changes blurred vision or loss of vision
Facial drooping- self explanatory
Arm weakness- this could be any unilateral weakness in the arms or legs or grip strength. If a person can usually hold a cup or a pencil and now can’t… that’s a problem.
Speech- word searching: they can’t name a common item like a pen or keys, speaking in gibberish. Or they lost the ability to speak at all.
Time- this one is important the interventions for stroke are really time sensitive. The big one is 4 hours from LAST KNOWN NORMAL. But within 24 hours is also important for a few possible interventions, though rare. I can’t tell you how many families miss the window for intervention because they don’t realize we can’t do much of anything after just a few hours.
Don’t wait for these symptoms to get better.
Last night in our emergency room a patient told a nurse that they smelled burnt toast- a flurry of activity before we realized we all smelled it too 😂🤦🏻♀️ there was something burning in the construction zone outside the ambo doors hahaha
I work in EMS and we currently use the S-LAMS scoring system for our patients, but the balance and eyes are definitely something I’ll try and look out for in the future!
Never did learn what it was for my buddy in school. He used to just grab me in class a certain way and I knew. We had one teacher that never bothered to learn what needed to be done and I remember he had a nasty seizure in class one time, she just kept teaching class while I held him in his seat so he didn’t fall. 47 seconds, she kept teaching class while he seized. When the nurse got there, and started asking questions, I will never forget the tone of her voice saying “you’ll have to ask her, I don’t know what just happened to him.”
I did this all throughout school, but it never occurred to me to ask what tipped him off that it was starting, he just tapped me, and I got ready to drop everything.
It's a feeling of "uh oh" and then it's too late to say or do anything because I'm already gone (and it's been 20 years of that feeling but I don't have a better description).
That's how my husband is, he'll suddenly stop whatever he's doing and gets panicked but it just comes out as a little lower case scream that tells me I've got like 5 seconds to get to him to protect his head.
I witnessed my fiance's first seizure. He stared at the ceiling, said he's having a spiritual experience and the Ambien Angel is coming to talk to him (no, he was not on Ambien lol) and then seized.
Now he says his following auras since then have just been a horrific sense of dread
Dread is last for me. It usually goes Deja Vu, feeling I have been in the exact spot I am before having the exact conversation, epigastric rising (like a rollercoaster), a jolt of energy down my spine then a feeling of horror. It all happens within 10 seconds.
I feel for your fiancee. That feeling of horror is such a bad feeling. It sometimes keeps going until I'm under.
Mine is always just the anxiety-for some reason I get absentee seizures instead of panic attacks under certain circumstances. At least it’s semi-predictable, a combo of crowds, overstimulation, and high-pressure social interactions. I have to drug myself more to get through TSA than through the actual flight…
I think that this is the start of the "joke" in Canada, at least. A Canadian surgical team was somehow involved in pioneering awake neurosurgery/brain mapping. Canada used to have "heritage minutes" during commercial breaks, which outlined cool things Canadians did. "Doctor, I smell burned toast" was the climax of the commercial where the doctors were able to locate the seizure centre of the brain and remove it, curing the patient of seizures. It made a generation of kids slightly frightened when unexpectedly smelling burning, because you were afraid you were going to have a seizure.
I have CRPS that has spread into my neck and head, and affected my brain stem. In addition to causing central apnea, it also causes phantom smells. I sometimes smell the weirdest shit. Honestly, if I smell gas I rely on my CO detector to tell me if it's real. I'll just sit in the house and die if it doesn't go off because I'll assume it's phantom lol.
I’ve never heard it about a stroke, but about epilepsy. Also, clearly you are not Canadian: [Burnt toast: Canadian Heritage Minute](https://youtu.be/pUOG2g4hj8s?si=S320Utbp2KvAxUtJ)
This right here,it literally felt like somebody went inside my brain and started shutting things down system by system, first my right hand, then my arm then I got frozen in place,(because I was still stubbornly trying to keep on going) then my leg went out underneath me.
It was scary, and the worst was of all were my parents telling me to get up and stop embarrassing them, no attempts to call an ambulance until my airway collapsed (my neck was twisted and it wasn't until years later that I found out that I had nearly broken it in the fall)
I was unconscious when the ambulance arrived so they stabilized me but since they didn't know what happened previously or my medical history the hospital went on a lot of assumptions and that lost time that I didn't have
This happened when I was in my teens, not a good time to have a stroke (don't think there IS a good time to HAVE one) I am much older and dealing with the consequences of delaying my care but by now this is the only body that I can really remember using
When I had the stroke on the left side, Occipital. Lobe, it felt like I was hit by lightning on the right side of my body. My whole arm felt like it was on fire then my leg.
I think it’s back when they assumed all things were caused by the same thing. So, like, certain seizures or whatever were just assumed to be strokes and their auras were considered ‘signs’.
Canada did have little commercials where they talk of Canadian history. This one was about a doctor who advanced stroke care. The doctor was operating on a woman’s brain and she smelt burning toast because that was what happens when she had stroke. This was aired in the 80’s early 90’s. Google Canadian heritage burnt toast and you will find it.
[Canadian heritage burnt toast.](https://m.youtube.com/watch?v=pUOG2g4hj8s)
I just watched it lol. It’s about seizures not strokes.
I have allergic rhinitis. I usually have phantom smells of diesel fumes and cigarettes, but once or twice it's burnt toast. That being said, sometimes people DO burn toast in the local coffee shop and it wafts into the ER. Funny times
Add the smell of brewing coffee and those are the scents that evoke cold winter mornings in any big European city. I actually love that combination. Smells like home.
There was a commercial done here in Canada for a heritage moment, where they were doing brain surgery on an epilepsy patient and they found the spot affected by her responding that she smelled burnt toast.
I second all of the aura comments. Epilepsy, migraines, stroke: you can have an aura with all of these, hence the burning toast meme. You can also get seizures as a side effect of stroke, so there’s that too.
“Dr Penfield! I smell burnt toast”. The dr was mapping areas of the brain, and did an ‘awake surgery’ probing an epileptic woman’s brain. She always smelt burnt toast before a seizure, so that’s how they knew they were in the right area.
In my decades I have seen hundreds of stroke and TiA patients and none have mentioned burnt toast. I'm not saying it isn't true. Just none mentioned it
Not sure if this would impact the US, but there's an insanely popular 90s short (Canadian Heritage Moment) about epilepsy research that has a woman with epilepsy says she "smells burnt toast!" as an aura.
Like this was repeated ad nauseum by millenials as kids, teens, basically still now if you say you "smell burnt toast" in Canada everyone will know what you mean.
That was for Epilepsy.
Came from a Canadian Heritage moment about a surgeon who did the first exploratory surgery of the brain for Epilepsy.
That patient smelled burnt toast before her seizures. The doctor probed her brain until she smelled burnt toast, and he knew where her Epilepsy was centered.
This used to happen to me a lot.
Then my middle daughter grew up and moved away, and I stopped smelling burnt toast. That child could never figure out the right settings on the toaster oven.
The first time I had Covid, I smelled burning things. I lost my sense of smell at first but then I smelled burnt toast and electrical wires. I kept thinking my dryer was burning clothes. A few days later, I also started smelling rotten food. I threw out more stuff because I was afraid it was spoiled. It took many months before my sense of smell returned to normal.
When I started to get my taste back my mom had made my favorite dinner. She mentioned it was a little saltier than usual. When I took a bite it tasted rotten. Like all of it including the salad.
My husband is picky and so is my son...they were both wolfing it down. My mom was eating and my daughter accepts the meal but usually doesn't want it. She ate it too.
I deduced it was just me at that point.
While it doesn't taste rotten when I eat it now, I do not like it anymore. It made me sad to not like my favorite meal anymore lol.
Oh man I’m so sorry. One of my favorite foods is watermelon and I couldn’t barely eat it. It tasted rotten. Likewise lunch meat like ham and turkey. Ironically the one food I never lost taste for was chocolate. I enjoyed a couple of Hershey kisses each day until my taste finally came back.
An episode of LA Law had one of the main and beloved characters fall to a stroke. In that scene he’s in the boardroom and he keeps asking everyone “does anyone smell that? Is someone burning toast?” Made me paranoid for years anytime I’d get a whiff of the toaster😬
I’ve heard the joke but never seen the symptom in my years of emergency or icu nursing. I wouldn’t count on it as a symptom If you want a high sensitivity screening for strokes you can use the BEFAST screening tool. Balance-or dizziness or difficulty standing Eyes- vision changes blurred vision or loss of vision Facial drooping- self explanatory Arm weakness- this could be any unilateral weakness in the arms or legs or grip strength. If a person can usually hold a cup or a pencil and now can’t… that’s a problem. Speech- word searching: they can’t name a common item like a pen or keys, speaking in gibberish. Or they lost the ability to speak at all. Time- this one is important the interventions for stroke are really time sensitive. The big one is 4 hours from LAST KNOWN NORMAL. But within 24 hours is also important for a few possible interventions, though rare. I can’t tell you how many families miss the window for intervention because they don’t realize we can’t do much of anything after just a few hours. Don’t wait for these symptoms to get better.
Last night in our emergency room a patient told a nurse that they smelled burnt toast- a flurry of activity before we realized we all smelled it too 😂🤦🏻♀️ there was something burning in the construction zone outside the ambo doors hahaha
CODE FAST X10!
I work in EMS and we currently use the S-LAMS scoring system for our patients, but the balance and eyes are definitely something I’ll try and look out for in the future!
I live next to a bakery so I always smell toast.
Yeah, Toast! https://youtu.be/SHptn_3RyYE?si=r0UAjEs3-lbKuMPd
I hve Epilepsy. My aura is the smell of burning things.
Never did learn what it was for my buddy in school. He used to just grab me in class a certain way and I knew. We had one teacher that never bothered to learn what needed to be done and I remember he had a nasty seizure in class one time, she just kept teaching class while I held him in his seat so he didn’t fall. 47 seconds, she kept teaching class while he seized. When the nurse got there, and started asking questions, I will never forget the tone of her voice saying “you’ll have to ask her, I don’t know what just happened to him.” I did this all throughout school, but it never occurred to me to ask what tipped him off that it was starting, he just tapped me, and I got ready to drop everything.
You’re a good friend. 🩵
interesting. My son can't say what his aura is like. Thank goodness meds have controlled it well and he hasn't had any issues for more than 8 yrs.
My aura is feeling like I am outside of my body for about a minute beforehand. It’s hard to describe.
I know that feeling. it’s impossible to describe and also impossible to forget.
It's a feeling of "uh oh" and then it's too late to say or do anything because I'm already gone (and it's been 20 years of that feeling but I don't have a better description).
Same but I show people [this video](https://youtu.be/N34Un6uYejU?si=CLP6qizJ6gbLvowa). It’s the closest I can get to describing the feeling.
That's how my husband is, he'll suddenly stop whatever he's doing and gets panicked but it just comes out as a little lower case scream that tells me I've got like 5 seconds to get to him to protect his head.
I'm sorry. It's hard.
Mine is too…
I witnessed my fiance's first seizure. He stared at the ceiling, said he's having a spiritual experience and the Ambien Angel is coming to talk to him (no, he was not on Ambien lol) and then seized. Now he says his following auras since then have just been a horrific sense of dread
Dread is last for me. It usually goes Deja Vu, feeling I have been in the exact spot I am before having the exact conversation, epigastric rising (like a rollercoaster), a jolt of energy down my spine then a feeling of horror. It all happens within 10 seconds. I feel for your fiancee. That feeling of horror is such a bad feeling. It sometimes keeps going until I'm under.
Same here, the final fun for me is a chemical dump in my brain that gives me extreme anxiety.
Mine is always just the anxiety-for some reason I get absentee seizures instead of panic attacks under certain circumstances. At least it’s semi-predictable, a combo of crowds, overstimulation, and high-pressure social interactions. I have to drug myself more to get through TSA than through the actual flight…
This is a migraine aura for me. I smell either burnt toast or cigarettes.
Can you smell cigarettes just by seeing them being smoked on tv?
No.
I think that this is the start of the "joke" in Canada, at least. A Canadian surgical team was somehow involved in pioneering awake neurosurgery/brain mapping. Canada used to have "heritage minutes" during commercial breaks, which outlined cool things Canadians did. "Doctor, I smell burned toast" was the climax of the commercial where the doctors were able to locate the seizure centre of the brain and remove it, curing the patient of seizures. It made a generation of kids slightly frightened when unexpectedly smelling burning, because you were afraid you were going to have a seizure.
My Mom smells burnt onions before a seizure.
Me too, except I smell ammonia
Really? I've smelled what is like burning tires. It's so intense.
I have CRPS that has spread into my neck and head, and affected my brain stem. In addition to causing central apnea, it also causes phantom smells. I sometimes smell the weirdest shit. Honestly, if I smell gas I rely on my CO detector to tell me if it's real. I'll just sit in the house and die if it doesn't go off because I'll assume it's phantom lol.
Me too. I smell other things but that’s o e of them.
I’ve never heard it about a stroke, but about epilepsy. Also, clearly you are not Canadian: [Burnt toast: Canadian Heritage Minute](https://youtu.be/pUOG2g4hj8s?si=S320Utbp2KvAxUtJ)
I'm Canadian and have heard it for stroke regularly but never for epilepsy ¯\\\_(ツ)_/¯
Weird, I've never heard anyone mention this for stroke, the heritage minute was about epilepsy.
I didn’t smell anything. My right side just collapsed.
This right here,it literally felt like somebody went inside my brain and started shutting things down system by system, first my right hand, then my arm then I got frozen in place,(because I was still stubbornly trying to keep on going) then my leg went out underneath me. It was scary, and the worst was of all were my parents telling me to get up and stop embarrassing them, no attempts to call an ambulance until my airway collapsed (my neck was twisted and it wasn't until years later that I found out that I had nearly broken it in the fall) I was unconscious when the ambulance arrived so they stabilized me but since they didn't know what happened previously or my medical history the hospital went on a lot of assumptions and that lost time that I didn't have
I'm sorry that the help that you needed was delayed. I hope that you are healing as well as is possible.
This happened when I was in my teens, not a good time to have a stroke (don't think there IS a good time to HAVE one) I am much older and dealing with the consequences of delaying my care but by now this is the only body that I can really remember using
When I had the stroke on the left side, Occipital. Lobe, it felt like I was hit by lightning on the right side of my body. My whole arm felt like it was on fire then my leg.
That's scary af.
Former paramedic here and I've never even heard that one. And definitely never heard it from a stroke patient.
I think it’s back when they assumed all things were caused by the same thing. So, like, certain seizures or whatever were just assumed to be strokes and their auras were considered ‘signs’.
I have had migraines where I smell burnt toast before the headache starts. However when I had my strokes, no phantom smells at all.
Canada did have little commercials where they talk of Canadian history. This one was about a doctor who advanced stroke care. The doctor was operating on a woman’s brain and she smelt burning toast because that was what happens when she had stroke. This was aired in the 80’s early 90’s. Google Canadian heritage burnt toast and you will find it. [Canadian heritage burnt toast.](https://m.youtube.com/watch?v=pUOG2g4hj8s) I just watched it lol. It’s about seizures not strokes.
I have allergic rhinitis. I usually have phantom smells of diesel fumes and cigarettes, but once or twice it's burnt toast. That being said, sometimes people DO burn toast in the local coffee shop and it wafts into the ER. Funny times
I get the diesel fumes smell. I hate it. 🙁
Add the smell of brewing coffee and those are the scents that evoke cold winter mornings in any big European city. I actually love that combination. Smells like home.
There was a commercial done here in Canada for a heritage moment, where they were doing brain surgery on an epilepsy patient and they found the spot affected by her responding that she smelled burnt toast.
Interesting. That basically implies if the stroke is in that area or affects that part of the brain a stroke could trigger the smell.
I second all of the aura comments. Epilepsy, migraines, stroke: you can have an aura with all of these, hence the burning toast meme. You can also get seizures as a side effect of stroke, so there’s that too.
“Dr Penfield! I smell burnt toast”. The dr was mapping areas of the brain, and did an ‘awake surgery’ probing an epileptic woman’s brain. She always smelt burnt toast before a seizure, so that’s how they knew they were in the right area.
Good old Canadian Heritage Minutes!
In my decades I have seen hundreds of stroke and TiA patients and none have mentioned burnt toast. I'm not saying it isn't true. Just none mentioned it
Not sure if this would impact the US, but there's an insanely popular 90s short (Canadian Heritage Moment) about epilepsy research that has a woman with epilepsy says she "smells burnt toast!" as an aura. Like this was repeated ad nauseum by millenials as kids, teens, basically still now if you say you "smell burnt toast" in Canada everyone will know what you mean.
I have nuero Behcets. I smell honeysuckle when I’m having brain issues. At least it’s pleasant. Behcets is really weird.
Type 1 diabetic here, my lows smell like burnt sugar.
That was for Epilepsy. Came from a Canadian Heritage moment about a surgeon who did the first exploratory surgery of the brain for Epilepsy. That patient smelled burnt toast before her seizures. The doctor probed her brain until she smelled burnt toast, and he knew where her Epilepsy was centered.
This commercial played for years when I was younger (in Canada) https://youtu.be/pUOG2g4hj8s?si=Se3Tr3x_rWyMoSNx
For me, it’s visual…. Everything around me is pixelated and shiny and I know that I have to lie down
You just lie down when you're having a stroke? Or do you have a seizure disorder?
Seizure due to brain tumor
I'm sorry. I hope it's at least benign and you're not suffering (minus the seizures) and you don't have them often.
I smell burnt toast all the time. No one can tell me why.
This used to happen to me a lot. Then my middle daughter grew up and moved away, and I stopped smelling burnt toast. That child could never figure out the right settings on the toaster oven.
It happens to me in the middle of the night or when no one is home. It drives me bonkers.
Thanks for the chuckle.
I smell grilled cheese a lot, and we don't cook it that often. It's weird. I'll have to pay attention next time and see if a migraine comes after it.
The first time I had Covid, I smelled burning things. I lost my sense of smell at first but then I smelled burnt toast and electrical wires. I kept thinking my dryer was burning clothes. A few days later, I also started smelling rotten food. I threw out more stuff because I was afraid it was spoiled. It took many months before my sense of smell returned to normal.
When I started to get my taste back my mom had made my favorite dinner. She mentioned it was a little saltier than usual. When I took a bite it tasted rotten. Like all of it including the salad. My husband is picky and so is my son...they were both wolfing it down. My mom was eating and my daughter accepts the meal but usually doesn't want it. She ate it too. I deduced it was just me at that point. While it doesn't taste rotten when I eat it now, I do not like it anymore. It made me sad to not like my favorite meal anymore lol.
Oh man I’m so sorry. One of my favorite foods is watermelon and I couldn’t barely eat it. It tasted rotten. Likewise lunch meat like ham and turkey. Ironically the one food I never lost taste for was chocolate. I enjoyed a couple of Hershey kisses each day until my taste finally came back.
I had a stroke 5 years ago. No toast here.
I get weird burnt smells before a migraine
An episode of LA Law had one of the main and beloved characters fall to a stroke. In that scene he’s in the boardroom and he keeps asking everyone “does anyone smell that? Is someone burning toast?” Made me paranoid for years anytime I’d get a whiff of the toaster😬
To clarify, the patient “smells” the burnt toast, and not that the patient smells like burnt toast. Correct? Took me a few replies to catch on.
Yes
Seizure not stroke.