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5 Diagnoses That Call for a Second Opinion

Experts tell WebMD about situations in which another medical viewpoint may be priceless.
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2. ADHD in Children Under Age 6 continued...

"Many of the symptoms are common among preschool children," Rizvi says. "Part of it is because of their developmental stage and level of activity and normal short attention spans." A second opinion can help determine if symptoms are serious enough to be classified as ADHD.

It's also crucial to rule out other mental disorders that can be confused with ADHD, according to Rizvi. These include developmental problems, learning disabilities, anxiety, and depression. Sometimes, children who witness domestic violence may behave in ways that suggest ADHD, Rizvi says. "They tend to be more inattentive to their class work, more impulsive. A lot of those children are actually misdiagnosed with ADHD when in fact they may be manifesting symptoms of posttraumatic stress disorder."

3. Parkinson's Disease

"Parkinson's is one of the most difficult diseases to diagnose. There's no blood test, X-ray, or instrument that would give you an answer," says Executive Director Robin Elliott of the Parkinson's Disease Foundation.

Diagnosis of this neurological disorder -- marked by tremors, slow movement, muscle stiffness, and loss of balance -- is based "not on a very specific test, but a cluster of features," says David C. Dale, MD, president of the American College of Physicians. Parkinson's can be especially difficult to diagnose in the early stages.

The rate of misdiagnosis among people with Parkinson's may be as high as 25%-30%, Elliott says. In the elderly, the trembling and movement problems of Parkinson's may be dismissed as normal aging. Conversely, patients may be wrongly diagnosed with Parkinson's when their symptoms actually stem from side effects of drugs they're taking, such as certain psychiatric medicines.

Even well-trained internists and general neurologists can have trouble diagnosing Parkinson's disease, especially if they've had little experience with the disorder, according to Elliott. As a result, the Parkinson's Disease Foundation suggests that people diagnosed with Parkinson's consider getting a second opinion from a neurologist who specializes in movement disorders and has extensive experience with Parkinson's.

4. Heart Procedures

What prompts heart patients to seek second opinions?

"Probably the most common situation is that someone has been advised to have open heart surgery or a coronary intervention or a catheterization, and they're wondering if they really need that," says David L. Rutlen, MD, vice chairman of ambulatory programs at the Froedtert and Medical College of Wisconsin, which has a cardiac second opinion program. In other words, patients want extra advice before consenting to invasive heart procedures that carry serious risks, such as blood clots, stroke, infection, and even death.

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