The diagnosis of amyotrophic lateral sclerosis (ALS) is one of exclusion, relying on the identification of upper and lower motor neuron features.  Far too often ALS patients are midiagnosed with radiculoapthy potenitally resulting in unncessary surgery.  While this was seen as a inconvnience, in the June issue of JNNP Pinot and colleagues report on a far more sinister effect.  Specifcially, the surgery was associated with a more rapid rate of disease progression and thereby morbidity and mortality.   This study underscores the importance of an accurate diagnosis, but also discretion on the part of the physician/surgeon.

Read more at http://jnnp.bmj.com/content/85/6/643.abstract