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The misdiagnosis of unilateral presentations of amyotrophic lateral sclerosis
Author(s) -
O'Reilly Daniel F.,
Brazis Paul W.,
Rubino Frank A.
Publication year - 1982
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880050910
Subject(s) - amyotrophic lateral sclerosis , medicine , age of onset , pediatrics , physical therapy , physical medicine and rehabilitation , disease
Fifty‐eight patients with definite amyotrophic lateral sclerosis (ALS) were investigated retrosectivley. Variables investigated included the age of onset of motor symptoms, the sex of the patient, the presenting signs and symptoms, and the initial clinical diagnosis. The patients were separated by mode of onset into five clinical categories: I. Conventional or Classical (31%); II Predominantly bulbar (19%); III. Pseudopolyneuritic (5.2%); IV. Paraparetic (13.8%); and V. Hemiparetic or Mills' Variant (31%) presentations. The average age of onset of symptoms was 55.3 years, with little difference among the clinical groups except for a later age of onset in the bulbar form. The initial diagnosis of ALS was correct in 95% of the patients with a predominantly bilateral mode of onset of symptoms (the conventional, bulbar, and paraparetic groups) but was correct in only 38% of patients with predominantly unilateral onset (hemiparetic) and pseudopolyneutric forms. We suggest that the clinician be aware of these atypical, unilateral forms of ALS in order that an accurate diagnosis may be made.