Intravenous thrombolytic treatment of ischemic stroke is the central treatment option in patients presenting with acute stroke symptoms. The thrombolytic treatment chain is initiated in the emergency services call center immediately after stroke is suspected. Even one point on the FAST scale mandates urgent transport for assessment of thrombolytic treatment. The FAST test identifies eight out of ten strokes, and the stroke diagnosis is confirmed in the emergency department with immediate imaging. The most significant groups of differential diagnosis include epileptic seizures, migraine, incoherence associated with infection, syncope and psychiatric states. There is every reason to hasten the confirmation of diagnosis and implementation of treatment at all stages of the treatment chain.