Two cases with motor neuron disease misdiagnosed as chronic obstructive pulmonary disease and literature review

Objective To improve the clinical doctors' consciousness with motor neuron disease (MND) whose main symptoms are similar with respiratory disease, reduce misdiagnosis. Methods A retrospective analysis of two patients with MND misdiagnosed as chronic obstructive pulmonary disease for many times.A literature research was performed with " motor neuron disease" as the Chinese key word in China national knowledge internet, Wan-fang database.The time interval was from January 1990 to February 2016. Results The patients with 64.5 years old on average had a history of shortness of breath.Pulmonary function test appeared restriction of ventilation function and blood gas analysis showed hyoxemia without the retention of carbon dioxide.Finally, two patients were diagnosed MND by neurologist according to electromyography which presented lesions of motor neurons.Literature review found 341 patients with MND whose were misdiagnosed as cervical spondylosis (206 cases), cerebrovascular disease (46 cases), lumbar spondylosis (27 cases), and chronic bronchitis (10 cases) in the top four.Twenty-six cases from 12 article were misdiagnosed as chronic bronchitis, pneumonia, chronic obstructive pulmonary disease, pulmonary hypertension, pulmonary interstitial fibrosis, bronchiectasis and asthma because these cases had main symptoms with respiratory diseases. Conclusions MND presented with non-specific clinical signs, which were misdiagnosed easily, as respiratory diseases when the symptoms are similar with respiratory disease.Therefore, doctors should pay attention to detailed history taking, systematic physical examination, pulmonary function test and blood gas analysis. Key words: Motor neuron disease; Chronic obstructive pulmonary disease; Misdiagnosis