Diagnostic problems and delay of diagnosis in amyotrophic lateral sclerosis
Diagnostic problems and delay of diagnosis in amyotrophic lateral sclerosis
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DOI：
10.1016/j.clineuro.2009.10.014
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发表时间：
2010-02-01
影响因子：
1.9
通讯作者：
Berlit, Peter
中科院分区：
文献类型：
--
作者：
Kraemer, Markus;Buerger, Melanie;Berlit, Peter
目的：肌萎缩侧索硬化症(ALS)的首发症状类似于几种神经综合征，这可能会降低正确诊断的速度。方法：我们回顾了100例ALS患者的临床和诊断资料，重点分析了ALS的临床和诊断资料、诊断的时机和出现症状的治疗方法。结果：在100例ALS患者中，12%的患者因ALS症状而接受手术治疗。从首发症状到正确诊断的时间比较，手术组和非手术组差异有统计学意义。35%的ALS患者有延髓症状。从首发症状到确诊的平均时间为9个月。在无球部发病的患者中为16.4个月，也有显着性差异。44%的患者在正确诊断之前考虑过其他诊断并进行了药物治疗，但诊断没有明显延误。结论：我们的研究证实了ALS的诊断仍然是一个常见的临床问题，并表明需要进行敏感和特异的诊断试验。(C)2009爱思唯尔B.V.保留所有权利。
Objective: Initial symptoms of amyotrophic lateral sclerosis (ALS) mimic several neurological syndromes that may decelerate a correct diagnosis. The aim of our study was to investigate if diagnostic and therapeutic parameters have influence on the time of diagnosis.Methods: We retrospectively reviewed the medical records of 100 consecutive ALS patients focusing on clinical and diagnostic data, the timing of diagnosis and treatments attributed to the onset of symptoms of ALS.Results: Among 100 consecutive patients with ALS, 12% underwent surgery due to symptoms retrospectively attributable to ALS. The comparison of duration from first symptoms to correct diagnosis showed a significant difference between operated and non-operated patients. 35% of all ALS patients had bulbar onset symptoms. The mean time from first symptoms to diagnosis was 9 months in this group. In patients without bulbar onset it was 16.4 months which also represents a significant difference. In 44% of patients other diagnoses were considered and medically treated previous to correct diagnosis, but there was no significant delay of diagnosis.Conclusion: Our study confirms that diagnosis of ALS is still a common clinical problem and shows the need of sensitive and specific diagnostic tests. (C) 2009 Elsevier B.V. All rights reserved.