Inappropriate surgeries in amyotrophic lateral sclerosis: a still considerable issue

Area of Science:

• Neurology
• Neurosurgery

Background:

• Amyotrophic lateral sclerosis (ALS) presents with diverse clinical symptoms, often mimicking other neurological conditions.
• This diagnostic variability can lead to delayed or incorrect diagnoses, potentially resulting in unnecessary surgical interventions.

Purpose of the Study:

• To evaluate the incidence and impact of misdiagnosis leading to unnecessary surgical treatments in amyotrophic lateral sclerosis (ALS) patients.
• To identify factors contributing to diagnostic delays and inappropriate surgical procedures in ALS.

Main Methods:

• Retrospective review of medical records from 164 consecutive amyotrophic lateral sclerosis (ALS) patients.
• Data collection focused on initial clinical presentation, presenting symptoms, diagnostic timelines, and surgical procedures performed.

Main Results:

• A total of 13 out of 164 (7.9%) ALS patients received surgical treatment due to a misdiagnosis.
• No statistically significant difference in the time to diagnosis was observed between surgically treated and non-operated ALS patients.

Conclusions:

• A notable proportion of amyotrophic lateral sclerosis (ALS) patients are misdiagnosed, leading to inappropriate surgical treatments.
• Increased awareness among non-neurologist specialists is essential to prevent misdiagnosis and ensure prompt referral to neurologists for accurate ALS diagnosis and management.