Neurologists explain how to use BEFAST method to recognise a stroke, warning signs and risk factors | Health

Without enough oxygen and nutrients, brain cells begin to die within minutes. Therefore, during a stroke, every minute counts. A stroke interrupts blood flow to the brain, causing brain cells to die. Neurologists say sudden symptoms need urgent assessment and prompt treatment.One in four individuals is likely to have a stroke at some point in life, according to global data from the World Health Organisation and the World Stroke Organisation. Moreover, the Global Burden of Disease estimates that there were about 1.29 million incident strokes and 6,99,000 stroke-related deaths in India in 2019, showing how huge the burden is at the national level.

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Dr Arun Shah, director—neurosciences, Sir HN Reliance Foundation Hospital in Mumbai, in a conversation with HT Lifestyle, explained that a stroke is a medical emergency that can cause permanent disability or death if treatment is delayed. “A brain stroke occurs when the blood supply to part of the brain is interrupted or when a blood vessel within the brain bursts. Thus, without enough oxygen and nutrients, brain cells begin to die within minutes.” He further highlighted the key causes that increase the risk of stroke in India:

Dr Sachin Adukia, senior consultant, neurology, Dr L H Hiranandani Hospital in Mumbai, told HT Lifestyle that FAST is a simple way to recognise common warning signs, where F stands for Face: does one side droop when the person smiles?; A stands for Arms: can both arms be raised equally?; S stands for Speech: is speech slurred or difficult to understand?; T stands for Time: seek emergency medical help immediately if any sign appears.

However, it’s not foolproof. Dr Sachin highlighted a systematic review and meta-analysis conducted in 2022, which found that the pooled sensitivity is around 77%, implying that certain cases of stroke might be missed; therefore, even a negative FAST cannot rule out the possibility of a stroke. This is where BEFAST comes in, as it broadens the checklist.

B - Balance: Sudden dizziness, loss of balance, or difficulty walking.

E - Eyes: Sudden loss of vision, blurred vision, or double vision.

F - Face: One side of the face droops when smiling.

A - Arm: Sudden weakness or numbness in one arm or one side of the body.

S - Speech: Slurred speech, difficulty speaking, or difficulty understanding others.

T - Time: Call emergency services immediately. Every minute matters in stroke.

Any one of these signs warrants emergency medical attention without any delay, Dr Arun stressed. Meanwhile, Dr Sachin shared other warning signs include sudden one-sided numbness, confusion, difficulty understanding language or a severe, unexplained headache. “Not every such symptom indicates a stroke, but sudden onset demands urgent assessment,” he noted.

According to Dr Sachin, in a landmark 2006 paper in Stroke, neurologist Jeffrey Saver estimated that an untreated ischaemic stroke (when a blood clot or fatty plaque blocks an artery that carries blood and oxygen to the brain) destroys approximately 1.9 million neurons every minute.

“Although this is an estimate rather than a universal countdown, the message is clear: delays can mean lost brain function. Eligible patients may benefit from clot-dissolving medicines or mechanical thrombectomy, depending on the clinical and imaging findings,” Dr Sachin explained.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Krishna Priya Pallavi is a journalist with over 9 years of experience, covering health, fashion, pop culture, travel, wellness, entertainment, festivals, mental health, art, decor, fitness, and sex and relationships. She is an alumna of the Indian Institute of Mass Communication (IIMC), Dhenkanal, and holds an undergraduate degree in Journalism and Mass Communication from Guru Gobind Singh Indraprastha University, Delhi. Her strong academic foundation informs her analytical and detail-oriented approach to storytelling, helping her uncover stories where none seem to exist. Before joining Hindustan Times, Pallavi worked with some of India’s leading media organisations. She spent close to three years at India Today, where she honed her newsroom skills and developed a sharp editorial sensibility. She also worked for over a year and a half at Vagabomb, ScoopWhoop’s feminist digital platform, where she explored stories through a gender-sensitive, socially aware lens. Pallavi has a deep interest in global fashion trends and international fashion seasons, and enjoys interviewing celebrities and tracking pop culture movements—interests that frequently translate into engaging, reader-friendly stories. Alongside lifestyle and entertainment, she has a keen eye for impactful health and wellness journalism, regularly interacting with doctors, designers, and digital content creators to bring nuance and credibility to her work. Born and raised in Haryana, Pallavi remains deeply connected to her ancestral roots in Odisha. Her ability to spot fresh angles brings curiosity and depth to stories she pursues. When not chasing deadlines, she enjoys spending time with her dog, planning her next vacation, reading, running new trails, and discovering new destinations.Read More