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Reg Anesth Pain Med ; 42(5): 645-648, 2017.
Article in English | MEDLINE | ID: mdl-28665875

ABSTRACT

OBJECTIVE: We report a case of misdiagnosed neuralgic amyotrophy (brachial plexus neuritis, Parsonage-Turner syndrome). Our primary objective is to review the scientific basis for errors in clinical reasoning. CASE REPORT: We herein report a patient in whom signs and symptoms compatible with neuralgic amyotrophy presented after shoulder surgery. The patient's brachial plexopathy was attributed incorrectly as a complication of interscalene brachial plexus block. The true diagnosis was made only after the patient developed neuralgic amyotrophy in the contralateral upper extremity after a subsequent shoulder surgery on that side, this time without a brachial plexus block. CONCLUSIONS: Cognitive bias may lead to errors in clinical reasoning and consequent misdiagnosis. Temporal proximity may falsely implicate regional anesthesia as the causative agent.


Subject(s)
Brachial Plexus Block/adverse effects , Brachial Plexus Neuritis/diagnosis , Brachial Plexus Neuropathies/diagnosis , Diagnostic Errors , Orthopedic Procedures/adverse effects , Shoulder Joint/surgery , Adrenal Cortex Hormones/administration & dosage , Brachial Plexus Neuritis/drug therapy , Brachial Plexus Neuritis/etiology , Brachial Plexus Neuritis/physiopathology , Brachial Plexus Neuropathies/etiology , Brachial Plexus Neuropathies/physiopathology , Humans , Male , Middle Aged , Predictive Value of Tests
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