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A lot of referrals to neurology are basically what I like to call 'lazy' referrals.
For example, you get a patient with paraparesis and instead of performing a detailed clinical evaluation, you shotgun some MRI and NCS and send a quick referral to neurology.
For example, you get a patient with paraparesis and instead of performing a detailed clinical evaluation, you shotgun some MRI and NCS and send a quick referral to neurology.
Since these investigations are poorly chosen and poorly aimed, the end result is mass confusion where localization goes for a toss.
General medicine has been particularly egregious in this regard.
General medicine has been particularly egregious in this regard.
If your knee jerk reaction is to just get an MRI LS spine for every low back pain, don't be surprised when the patient then develops an LMN type of lower limb weakness. Low back pain can be severe in GBS.
In this particular case, I knew that the LS spine imaging had not been well thought out.
Why?
Because if you are suspecting an early polyradiculopathy, you will need contrast enhancement of the roots --> but only plain imaging was done in this case.
Why?
Because if you are suspecting an early polyradiculopathy, you will need contrast enhancement of the roots --> but only plain imaging was done in this case.
I can understand this sort of mistakes in small centers, but large teaching institutions should avoid this kind of 'lazy' referrals, especially from General Medicine which is the mother subject of all the subspecialties.
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