[False negatives in the diagnosis of myasthenia gravis].
BACKGROUND
Myasthenia gravis is an uncommon disorder with very variable clinical findings. This often leads to errors in diagnosis.


OBJECTIVE
To study the main errors leading to false negatives in the diagnosis of myasthenia gravis.


METHODS
We carried out a questionnaire to determine all the doctors and diagnoses made by them in relation to symptoms of myasthenia graves in 109 patients in whom this diagnosis was later confirmed when a specialist was consulted.


RESULTS
Most of the patients went to a general practitioner first. During this initial consultation the disease was only diagnosed in 10 cases (9.2%) and neurosis was the most frequent diagnosis (27.5%). Although most patients had to see from two to four doctors before diagnosis was made, there was no major delay in this. In 84 of the 109 cases the diagnosis was established within the first six months, generally by a neurologist (86.2%) and less frequently by a general physician (11.0%).


CONCLUSIONS
General practitioners, ophthalmologists, psychiatrists and otorhinolaryngologists are often involved in the evaluation of these cases although they made little contribution to the diagnosis.
Pérez-Nellar
J
J
Servicio de Neurología, Hospital Hermanos Ameijeiras, La Habana, Cuba. jpnellar@yahoo.com
Rodríguez
A
A
D000328:Adult; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D009157:Myasthenia Gravis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index