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Suspected conversion disorder: foreseeable risks and avoidable errors.

T H Glick1, T P Workman, S V Gaufberg

  • 1Department of Neurology, Harvard Medical School, Cambridge, MA, USA. thomas_glick@hms.harvard.edu

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|November 10, 2000
PubMed
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Misdiagnosed neurologic emergencies, initially mistaken for psychogenic conditions, pose a significant risk for medical errors and patient harm in emergency departments. Enhanced diagnostic strategies and physician education are crucial for prevention.

Area of Science:

  • Neurology
  • Emergency Medicine
  • Psychiatry

Background:

  • Serious neurologic conditions are frequently misdiagnosed as conversion or psychogenic disorders in emergency departments.
  • This diagnostic challenge contributes to medical errors and potential patient harm.

Observation:

  • The authors reviewed cases within their emergency department, identifying a significant underrecognition of neurologic emergencies.
  • Thousands of such cases may occur annually in the U.S., leading to delayed or incorrect treatment.
  • Existing medical literature offers limited guidance for emergency physicians on this diagnostic dilemma.

Findings:

  • Diagnostic errors stem from the difficulty in distinguishing organic neurologic deficits from psychogenic symptoms.
  • Patient-specific risk factors and physician cognitive biases can influence diagnostic accuracy.

Related Experiment Videos

  • Systemic safety nets, including appropriate imaging and specialist consultations, are vital.

    • Implications:

    • Improved diagnostic accuracy for neurologic emergencies is essential to prevent patient injury.
    • Educational interventions focusing on diagnostic challenges, risk factors, and physician attitudes are recommended.
    • Integrating diagnostic safety nets into emergency department protocols can enhance patient care quality.