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Beyond Pain Intensity: A Patient-Informed Framework for Documenting Burden in Small Fiber Neuropathy

PubMed - small fiber neuropathy Published 13 Oct 2026 Relevancy: 79%

Small fiber neuropathy (SFN) is a sensory-autonomic neuropathy of thinly myelinated Aδ and unmyelinated C fibers that can produce neuropathic pain and multisystem autonomic symptoms. Although diagnostic criteria and confirmatory testing have improved recognition, SFN burden may remain underrecognized even after diagnosis. This narrative review identifies two complementary documentation failures. The translation problem arises when symptom labels and intensity ratings do not capture effects on...

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The Digital Imperative for Neuro-Otology

PubMed - diagnostic errors AND neurology Published 13 Oct 2026 Relevancy: 65%

This article highlights the growing role of digital medicine in transforming the diagnosis and management of dizziness, vertigo, and other vestibular disorders. Advances such as video-oculography, video head impulse testing, smartphone-based diagnostic tools, and artificial intelligence (AI)-driven clinical decision support systems have created opportunities to deliver expert vestibular care at scale. The authors emphasize that current clinical practice often fails vestibular patients because of...

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Rural Health and Atypical Stroke: Technology-Based Posterior Circulation Stroke Diagnosis

PubMed - diagnostic errors AND neurology Published 13 Oct 2026 Relevancy: 88%

Diagnostic errors cause an estimated 900,000 deaths and disabilities annually in the United States, and stroke is the leading cause of diagnostic error-related harm in US emergency departments. Posterior circulation strokes (PCS's) are frequently misdiagnosed due to atypical presentations such as dizziness. Key contributors to rural-urban care gaps in PCS diagnosis are highlighted for rural care (eg, challenges in bedside diagnosis and limited access to neurologists). Emerging technologies (eg,...

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How well do junior neurology residents recognize multiple sclerosis? Analysis of the "Close the Loop" resident clinical acumen project

PubMed - neurological misdiagnosis Published 13 Oct 2026 Relevancy: 92%

CONCLUSIONS: Acute multiple sclerosis/demyelinating disease presentations pose educational challenges for neurology residents, with errors primarily arising from misclassification of central nervous system etiologies. Diagnostic accuracy was influenced by prior disease history and patient age, highlighting cognitive biases such as framing and anchoring. Structured feedback models like "close the loop" may help improve multiple sclerosis diagnostic acumen in residency training and clinical...

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When dengue is not the answer: diagnostic anchoring bias in febrile illnesses in conflict-affected settings

PubMed - neurological misdiagnosis Published 13 Oct 2026 Relevancy: 61%

Dengue is an increasingly prevalent arboviral infection in tropical regions, with expanding geographic distribution and rising reports of atypical and severe manifestations, including neurological involvement. In endemic and resource-limited settings, particularly those affected by conflict, the widespread availability of rapid diagnostic tests and overlapping clinical presentations with other infectious diseases have led to a growing concern: diagnostic anchoring bias toward dengue. This bias...

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Diagnostic Decision Support and Automation in Vestibular Diagnosis

PubMed - neurological misdiagnosis Published 13 Oct 2026 Relevancy: 77%

This article examines the current and future role of decision-support systems and automation in vestibular diagnosis across emergency, primary care, and specialty settings. Vestibular disorders are common but often misdiagnosed because of overlapping symptoms, challenging bedside examinations, and limitations of neuroimaging. Structured diagnostic approaches improve accuracy when correctly applied. Emerging technologies offer objective assessment of eye movements and may enhance diagnostic...

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Homozygous PRRT2 mutation causing a spectrum of paroxysmal neurological symptoms responsive to sodium channel blockers

Practical Neurology - Online First Published 12 Oct 2026 Relevancy: 88%

Case presentation A 17-year-old woman attended the adult outpatient clinic with recent focal seizures, lasting approximately 30s, occurring several times a week. She experienced an odd sensation that she recognised but could not describe, followed by loss of consciousness. Her mother reported she would become blank and stare with swallowing movements. Occasionally, she would turn her head to the left, pluck at her clothes and make a low-pitched groan. These seizures occurred after carbamazepine (taken since early childhood) was weaned. She also reported intermittent tingling sensations, poor memory and hemiplegic migraine (HM). A clinical diagnosis of focal epilepsy, likely temporal, was made. A sleep electroencephalogram (EEG) showed several runs of bitemporal or independent epileptiform discharges, mainly right frontotemporal. Medical history Aged 2 months, she had her first generalised tonic-clonic seizure (GTCS) and was admitted with recurrent seizures, treated with phenobarbital, followed by carbamazepine and became seizure-free. At nearly 4 years of age,...

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Optimized RNA-seq workflow for routine diagnosis of mitochondrial diseases using aberrant expression analysis and phenotype-driven prioritization

PubMed - diagnostic errors AND neurology Published 12 Oct 2026 Relevancy: 70%

Mitochondrial diseases (MD) are the most common inherited metabolic disorders and show marked clinical and genetic heterogeneity. Despite widespread use of whole-exome (WES) and whole-genome sequencing (WGS), nearly half of patients remain without molecular diagnosis, partly due to difficulties in interpreting variants affecting RNA splicing or gene expression. RNA sequencing (RNA-seq) has shown promise in research settings, few studies have evaluated its feasibility in routine clinical...

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Taking a clinical history in adolescents and adults presenting with seizures or epilepsy

PubMed - neurological misdiagnosis Published 10 Oct 2026 Relevancy: 87%

Despite advances in EEG, neuroimaging, and other diagnostic technologies, a carefully obtained clinical history remains the cornerstone of diagnosis, classification, and treatment planning. However, structured guidance on history-taking that integrates state-of-the-art evidence and the updated 2025 International League Against Epilepsy (ILAE) seizure classification is limited. We performed a review of evidence published between January 2000 and April 2026, supplemented by landmark earlier...

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Bilateral upper-limb palsy of the newborn infant: Taxonomy, differential diagnosis, and clinical pathways

PubMed - neurological misdiagnosis Published 10 Oct 2026 Relevancy: 63%

Bilateral reduction or absence of upper-limb movement in a newborn infant is a rare but critical presentation that cannot be anchored on the unilateral paradigm of brachial plexus birth injury (BPBI). Bilaterality substantially widens the differential to include cervical spinal cord injury, neuromuscular disorders, and non-neurological movement limitation; thus, default attribution to bilateral BPBI risks missing a serious central pathology. No standardized terminology or investigation framework...

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