FACTORS AFFECTING THE DIAGNOSTIC DELAY IN AMYOTROPHIC LATERAL SCLEROSIS

Vincenzo La Bella, Rossella Spataro, Alfonsa Claudia Taiello, Eleonora Cellura

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Abstract

Background: Although amyotrophic lateral sclerosis (ALS) is a relentlessly progressive disorder, earlydiagnosis allows a prompt start with the specific drug riluzole and an accurate palliative care planning. ALSat onset may however mimic several disorders, some of them treatable (e.g., multifocal motor neuropathy)or epidemiologically more frequent (e.g., cervical myelopathy).Objective: To study the delay from onset to diagnosis in a cohort of ALS patients and to the variables thatmay affect it.Methods: We performed a retrospective analysis of the diagnostic delays in a cohort of 260 patientsaffected by ALS (M/F = 1.32) followed at our tertiary referral ALS Center between 2000 and 2007.Results: The median time from onset to diagnosis was 11 months (range: 6–21) for the whole ALS cohort,10 months (range: 6–15) in bulbar-onset (n = 65) and 12 months (range: 7–23) in spinal-onset (n = 195)patients (p = 0.3). 31.1% of patients received other diagnoses before ALS and this led to a significantdelay of the correct diagnosis in this group (other diagnoses before ALS, n = 81: median delay, 15 months[9.75–24.25] vs ALS, n = 179, median delay, 9 months [6–15.25], p < 0.001).Conclusions: The diagnostic delay in ALS is about one year, besides the growing number of tertiary centresand the spread of information about the disease through media and internet. Cognitive errors based onan incorrect use of heuristics might represent an important contributing factor. Furthermore, the lengthof the differential diagnosis from other disorders and delays in referral to the neurologist seems to bepositively associated with the delay in diagnosis.
Lingua originaleEnglish
pagine (da-a)550-554
Numero di pagine5
RivistaClinical Neurology and Neurosurgery
Volume114
Stato di pubblicazionePublished - 2012

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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