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Difficult-to-classify symptoms and syndromes in a series of 5398 neurological outpatients diagnosed according to ICD-10 criteria

L. Calandre-Hoenigsfeld, F. Bermejo-Pareja [REV NEUROL 2011;53:513-523] PMID: 22012814 DOI: https://doi.org/10.33588/rn.5309.2011498

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Volumen 53 | Number 09 | Nº of views of the article 6.889 | Nº of PDF downloads 1.123 | Article publication date 01/11/2011

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ABSTRACT

INTRODUCTION Outpatient pathology accounts for a large percentage of neurological clinical activity. A number of studies have been conducted on its epidemiological characteristics and management, but the content of the visits has rarely been analysed in detail. AIMS. To carry out a detailed analysis of standardised diagnoses according to the 10th revised edition of the International Classification of Diseases (ICD-10), in a long ambulatory series and to evaluate their repercussion on clinical activity.

PATIENTS AND METHODS The sample included the new consecutive cases seen in a general outpatients’ neurological clinic over a period of six years included in a database. They were classified retrospectively according to the ICD-10. An analysis was performed of the clinical features of the main groups in which the diagnosis was unspecific from the etiopathogenic point of view.

RESULTS Of the 5398 patients, 37.5% had an unspecific diagnosis. The unspecific diagnosis groups with the highest number of cases were: dizziness (n = 214), paraesthesias (n = 160), syncope/fainting (n = 144), gait ataxia (n = 136), gait disorders (n = 105), non-specified headache (n = 91), pain in one limb (n = 84), loss of memory (n = 83), unspecific vertigo (n = 76) and unspecific cognitive disorders (n = 57).

CONCLUSIONS In outpatient neurological pathology, it is not uncommon to come across cases in which it is difficult to reach the specific diagnosis. Clinical symptoms such as dizziness, instability or gait disorders often lack precise criteria with which to make a particular diagnosis. An approximation to certain diagnoses by means of the agreement of experts could be useful in several of these syndromes. KeywordsClassification Dementia Diagnosis Dizziness Gait Headaches Outpatients CategoriesCefalea y Migraña Demencia Dolor Mareos, vértigos y acufenos Neuropsiquiatría

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Original

Difficult-to-classify symptoms and syndromes in a series of 5398 neurological outpatients diagnosed according to ICD-10 criteria