The problem of Misdiagnosis: Ongoing problem even if you make the correct initial diagnosis
Joseph D.Weissman, Neurologist, Neurology Specialists of DecaturNimonitor@gmail.com
Submitted June 25, 2012
I read the two articles and the accompanying editorial [1] with interest. I often see this type of unclear diagnosis. In my geographic and demographic location, patients frequently switch care providers. One problem is getting the initial records of a patient who has been to multiple institutions and may not even remember who made the diagnosis. The second is that a patient may move on to another provider who may make a different or incorrect diagnosis.
Several years ago, I admitted a patient with progressive gait disorder and ultimately made a firm diagnosis of hereditary spastic paraparesis that was supported by molecular biological confirmation of HTLV-1 infection. The patient improved on steroid therapy and moved out of state. Recently, I received a complaint because the patient went to a new neurologist who told the patient that the diagnosis was MS. The complaint was to my state medical board so I was not able to contact the patient or the new neurologist to discuss the situation. However, the medical board agreed with my diagnosis.
Rudick RA, Miller AE.Multiple sclerosis or multiple possibilities: The continuing problem of misdiagnosis. Neurology 2012; 78: 1904-1906.
Acknowledgment: Dr. Adam Bressler was invaluable as an infectious disease consultant in this case.
For disclosures, contact the editorial office at journal@neurology.org.
I read the two articles and the accompanying editorial [1] with interest. I often see this type of unclear diagnosis. In my geographic and demographic location, patients frequently switch care providers. One problem is getting the initial records of a patient who has been to multiple institutions and may not even remember who made the diagnosis. The second is that a patient may move on to another provider who may make a different or incorrect diagnosis.
Several years ago, I admitted a patient with progressive gait disorder and ultimately made a firm diagnosis of hereditary spastic paraparesis that was supported by molecular biological confirmation of HTLV-1 infection. The patient improved on steroid therapy and moved out of state. Recently, I received a complaint because the patient went to a new neurologist who told the patient that the diagnosis was MS. The complaint was to my state medical board so I was not able to contact the patient or the new neurologist to discuss the situation. However, the medical board agreed with my diagnosis.
Rudick RA, Miller AE.Multiple sclerosis or multiple possibilities: The continuing problem of misdiagnosis. Neurology 2012; 78: 1904-1906.
Acknowledgment: Dr. Adam Bressler was invaluable as an infectious disease consultant in this case.
For disclosures, contact the editorial office at journal@neurology.org.