5 Diagnoses That Call for a Second Opinion
Experts tell WebMD about situations in which another medical viewpoint may be priceless.
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
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.