The 7 deadly sins of neurological misdiagnosis

The practice of medicine is a finely balanced art. Clinical features are often very subtle, and the ground is littered with booby traps. You could say medicine is a minefield, strewn with mimics and chameleons.

The Deadly Fat-tail Scorpion. Shaan Hurley on Flickr. https://www.flickr.com/photos/btl/2891129138

This explains why diagnostic error is rife in medicine, and this is perhaps more so in neurology.  Admittedly, some misdiagnoses only cause minor emotional trauma to the patient…and some  embarrassment to the neurologist. Other missed diagnoses are however supremely consequential because they prevent early curative treatment, and result in death or severe disability.

By Nancy Worden – Flickr Photo Stream of Nancy Worden: https://www.flickr.com/photos/64611864@N06/with/14559410804, CC BY-SA 2.5, Link

Below is our list of the deadliest neurological misdiagnoses. To limit ourselves to the iconic number 7, we had to exclude many serious diseases. These are conditions where the diagnosis, even though critical, is often obvious such as stroke. We have also excluded misdiagnoses which almost uniformly lead to death, such as brain tumours and motor neurone disease (MND). Below therefore are the 7 deadly sins of neurological misdiagnosis:  click on the links for their disastrous fallouts.

Deadly Sins. See-ming Lee on Flickr. https://www.flickr.com/photos/seeminglee/4053654517

***

Meningitis

Subarachnoid haemorrhage (SAH)

Giant cell arteritis (GCA)

Idiopathic intracranial hypertension (IIH)

Cerebral vein thrombosis (CVT)

Cervical artery dissection (CAD)

Encephalitis

***

Deadly Red. Kevin Rheese on Flickr. https://www.flickr.com/photos/129440207@N08/25749749536

Please feel free to disagree with this list, and recommend your own top 7.

Why not also check out our previous related blog posts:

The 12 most hazardous neurological pitfalls…and their checklists

The 13 most dreadful neurological disorders…and the groups standing up to them

The 7 most devastating viral neurological infections

The 7 most ruthless bacterial infections of the nervous system

The 8 most parasitic infestations of the nervous system

 

Published by:

Ibrahim Imam

I am a UK Neurologist keen on general neurology, but with an interest in neuromuscular diseases. I maintain the neurology searchable database, www.neurochecklists.com. I also blog at www.theneurologylounge.com. I share and discuss current issues around clinical neurology. I hope you find my blogs enlightening, practical, and even entertaining.

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