Diagnostic accuracy of neurological problems in the emergency department

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
Jeremy J MoellerVirender Bhan

Abstract

Previous studies describe significant rates of misdiagnosis of stroke, seizure and other neurological problems, but there are few studies examining diagnostic accuracy of all emergency referrals to a neurology service. This information could be useful in focusing the neurological education of physicians who assess and refer patients with neurological complaints in emergency departments. All neurological consultations in the emergency department at a tertiary-care teaching hospital were recorded for six months. The initial diagnosis of the requesting physician was recorded for each patient. This was compared to the initial diagnosis of the consulting neurologist and to the final diagnosis, as determined by retrospective chart review. Over a six-month period, 493 neurological consultations were requested. The initial diagnosis of the requesting physician agreed with the final diagnosis in 60.4% (298/493) of cases, and disagreed or was uncertain in 35.7% of cases (19.1% and 16.6% respectively). In 3.9% of cases, the initial diagnosis of both the referring physician and the neurologist disagreed with the final diagnosis. Common misdiagnoses included neurocardiogenic syncope, peripheral vertigo, primary headache and psychogenic synd...Continue Reading

References

Dec 1, 1995·Stroke; a Journal of Cerebral Circulation·R U KothariC A Hamilton
Jun 17, 1998·Stroke; a Journal of Cerebral Circulation·J M FerroA V Salgado
Nov 10, 1998·Seizure : the Journal of the British Epilepsy Association·B ScheepersC Pickles
Apr 21, 1999·QJM : Monthly Journal of the Association of Physicians·D SmithD W Chadwick
Nov 25, 2003·European Neurology·Thierry MoulinLucien Rumbach
Mar 24, 2004·Neurology·L B MorgensternJ M H Risser
Mar 28, 2006·Annals of Neurology·Steven L GalettaOrly Avitzur
Jun 30, 2007·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Colin B JosephsonR Mark Sadler

❮ Previous
Next ❯

Citations

Nov 8, 2011·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Giuseppe MicieliDanilo Toni
Apr 27, 2013·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Fabrizio A de Falco, Domenico Inzitari
Sep 4, 2014·The International Journal of Neuroscience·Manoj K MittalEelco F M Wijdicks
Jul 31, 2013·Annals of Emergency Medicine·Jahan FahimiHooman Kamel
Nov 28, 2012·Clinics in Geriatric Medicine·Alexander X Lo, Caroline N Harada
Dec 15, 2015·CJEM·Devin R HarrisSimon Pulfrey
Jan 7, 2010·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·H Angus-Leppan, J-P Leach
Oct 1, 2015·Headache·Barbara L Nye, Thomas N Ward
Mar 5, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Nitin GoyalRamin Zand
Jun 4, 2015·Irish Journal of Medical Science·N BroderickN Tubridy
Aug 1, 2015·International Journal of Emergency Medicine·Christopher K HansenJonathan A Edlow
Apr 2, 2014·BMC Research Notes·Rajib Nayan ChowdhuryShamim Ahsan
Feb 19, 2014·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·D J WileS Furtado
Dec 4, 2010·Eye·F J Rowe, UNKNOWN VIS Group
May 12, 2016·Der Nervenarzt·R LangeF Erbguth
Aug 27, 2019·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A T JonesA S David
Oct 3, 2015·Clinical Medicine : Journal of the Royal College of Physicians of London·Laura T AxinteSybil R L Stacpoole
Apr 30, 2011·Clinical Medicine : Journal of the Royal College of Physicians of London·Les Ala, Tom Hughes
Oct 1, 2019·The Journal of Head Trauma Rehabilitation·Alicia A SwanUNKNOWN Chronic Effects of Neurotrauma Consortium
Nov 2, 2012·The Neurologist·Mario A PérezValérie Biousse
Oct 3, 2020·AJNR. American Journal of Neuroradiology·C C McDougallP A Barber
Aug 14, 2012·Emergency Medicine International·Jennifer V Pope, Jonathan A Edlow
Jun 3, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·C HoyerK Szabo
Nov 21, 2014·Neuro-ophthalmology·Clare M GaltreyArani Nitkunan
Mar 15, 2020·The Journal of Headache and Pain·Andrea NegroPaolo Martelletti
May 2, 2018·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Vittorio GovoniEdward Cesnik
Aug 19, 2015·Journal of Graduate Medical Education·Michael D JainLuke A Devine
Jan 14, 2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Maximilian LutzWolf Ulrich Schmidt
Jan 20, 2021·The American Journal of Emergency Medicine·Sung Jin BaeSun Hwa Lee
Jan 6, 2010·The Medical Journal of Australia·Rebekah M AhmedSimon J G Lewis
Apr 19, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Sara A FinkelsteinJon Stone
Jul 13, 2021·Frontiers in Neurology·Chakrapani PathikondaRaghav Govindarajan
Aug 28, 2021·Acta neurologica Belgica·Antonio GranatoPaolo Manganotti

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.