The Telegraph
Since 1st March, 1999
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Doctors rue neuro mess-up cases

Akshay Ram Patel, president of the city’s Gujarati Association, was suffering from progressive paraplegia, a neurological problem that strikes the spinal cord. After knocking in vain at the doors of various general practitioners, Patel reached a point where he could not walk on his own. Finally, he decided to see a neurologist who identified his problem and put him through counselling sessions, as well as continuous rehabilitation at a centre, to address his ailment.

Concerned at the growing number of ‘wrongly-treated’ neurological cases, neurologists in the city have called for “greater awareness among general practitioners” and other non-neurological practitioners while dealing with such cases.

In a recent meeting to discuss the emerging problems, eminent neurologists also decided to undertake counselling sessions for patients, mostly advising them to stop visiting centres for physiotherapy and rehabilitation ill-equipped to handle such cases and to see specialists.

Trishit Roy, head of the department of neuro-medicine, Bangur Institute of Neurology (BIN), recently came across a case where a neurological patient had been undergoing psychiatric counselling over a long period of time. The psychiatrist continued with his experimentation till the patient’s condition worsened. “I found the patient, suffering from brain tumour, being treated by a psychiatrist. This is not an isolated case. We do get several such cases. I guess a greater amount of awareness among doctors as well as patients is required,” Roy said.

According to modest estimates, over 1,500 to 2,000 critical cases have been reported in neurology departments of around five private hospitals, including BIN, National Neurosciences Centre, Calcutta Medical Research Institute and a handful of neurological rehabilitation centres in the past three months. The trend of ‘messed-up’ cases landing in the neurologist’s hands is disturbing, say specialists.

“Of late, the number of such neurological and neuromuscular cases reaching us has been increasing by leaps and bounds. Many cases reach us when the condition of the patient is pretty bad,” says Mouli Madhab Ghatak, director and chief consultant of the Medical Rehabilitation Centre, which is recognised by the state government.

Last year, the Centre had handled 1,300 ‘mishandled’ cases, out of which 200 patients had to undergo “rigorous indoor rehabilitation” for more than a month to set things right. Around 800 of these cases came in the second half of the year, added Ghatak.

Neurosurgeon Ajay Agarwal advises patients to be careful about the physiotherapy centres they choose to visit. “Patients often require physiotherapy, but most centres offer yoga and massages, which is not physiotherapy at all,” warns Agarwal, adding that the onus is on general practitioners to understand the gravity of a case and immediately refer it to a neurologist.

“There are many cases where a neurological case manifests itself with a prolonged headache. A doctor has to be able to differentiate between an ordinary headache and a neurological problem,” adds Agarwal.

City neurologists have called for general practitioners to refer such cases to specialists more judiciously. “There are instances of an epilepsy case being referred to a neurologist, which I think a general practitioner is qualified to handle,” observes Trishit Roy.

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