Neurology Today article

Excerpt from a November 2002 article "How Neurologists Use the Internet to Enhance Clinical Decision-Making" by Orly Avitzur MD in the American Academy of Neurology's publication "Neurology Today":

If C. J. Malanga, MD, PhD had his way, neurologists would be required to - not left with the option of - learning how to use the Internet.... Dr. Malanga first discovered the benefits of the Internet as a child neurology fellow at Massachusetts General Hospital (MGH), trying to determine a differential diagnosis for a case posted on the weekly neuropathology conference.  The case involved a 15-year-old boy who was first seen at age 5 with slurred speech and gait instability and who continued to deteriorate over the next 10 years with emerging marked dystonia, dysphagia, tics and seizures.  

On their own, Dr. Malanga and fellow trainees came up with a long list of differential diagnoses.  But after entering important variables in query form into a Web site, www.simulconsult.com, the search was narrowed considerably to Friedreich ataxia, Hallervorden-Spatz, and Huntington chorea (akinetic-rigid form).  Autopsy revealed almost complete striatal atrophy with minimal cortical involvement.  The final diagnosis, confirmed by CAG repeat count, was juvenile Huntington disease.

Note:  Dr. Malanga ran this case through the software in May 2002.  The case can be viewed in the current version of the software at this link and registered users can click into the software to see the differential diagnosis (only the clinical findings were used) and work with the case.  Furthermore, adding the family history information (that the father was similarly affected but three siblings were not) using the family history feature added to the software after the Neurology Today article appeared, the correct diagnosis is elevated to #1 in the software by a wide margin.