ADHD Diagnosis and Misdiagnosis- 176 Problems That Can Look Like ADHD



There are many medical conditions, 176 in fact, that look like ADHD but that are actually caused by another medical problem.


*Academic/Learning Problems:


1. Dyslexia


2. Cognitive impairment


3. Specific learning disability


4. Giftedness


5. Memory discrimination problems


6. Mismatch of behavioral style and environmental expectations


7. Inappropriate educational setting


*Allergy Problems such as: 


8. Allergy induced Asthma


9. Allergic bronchitis


10. Allergic rhinitis, allergic sinusitis, allergic otitis


11. Wheat, lactose, peanut and other food allergies


12. Allergies to food dyes or preservatives


13. Chronic antihistamine use


Autoimmune disorders


14. AIDS


15. Pandas, Pediatric autoimmune neuropsychiatric disorders


16. Disorders or Carbohydrate metabolism


17. Autoimmune neurological disorders and encephalopathy


*Anemias including:



18. B vitamin deficiency anemia


19. Iron Deficiency


20. Sickle Cell Anemia


Biomedical Problems such as:


21. Lead poisoning


22. Arsenic exposure during development


23. Toluene exposure during development


24. Mercury poisoning


25. PCBs exposure


26. Manganese Poisoning


27. Carbon Monoxide Poisoning


28. Prenatal Cocaine Exposure


29. Fetal Alcohol Syndrome


30. Organophosphates intoxication


31. Asthma medication reactions


32. Seizure medication reactions


Chronic Illness


33. Viral Infections


34. Bacterial Infections


35. Parasitic Infection


36. Sequelae (symptoms resulting from) of acute infection/trauma


37. Chronic Asthma


38. Chronic Infections


39. Seizure Disorders


40. Sickle Cell Disease


41. Multiple Sclerosis


*Developmental Problems such as
:


42. Perceptual/processing disorders


43. Pervasive Normal developmental variation


44. developmental disorders


45. Development Disorders, not otherwise classified


Ear/Nose/Throat Problems such as:


46. Tonsil and adenoid hyperplasia


47. Chronic Ear Infection


48. Chronic Sinusitis


49. Chronic Upper Respiratory Infections


*Emotional Problems such as:


50. Separation anxiety


51. Social Anxiety


52. Generalized Anxiety


53. Attachment disorders


54. Social Skills Problems


*Psychosocial


55. Traumatic Events (house fires, major motor vehicle accidents)


56. Abuse (sexual, physical or emotional)


57. Loss by separation or death of a loved one


58. Mismatch of behavioral style and expectations


Genetic and or Chromosomal Problems such as:


59. Fragile X syndrome


60. Williams Syndrome


61. Mental retardation


62. Neurofibromatosis


63. XXY syndrome


64. Klinefelter Syndrome


65. XYY Disorder


66. Porphyria


*Hearing Problems such as:


67. Hearing deficits and Hearing loss


68. Auditory Processing problems


69. Auditory Discrimination problems


Infections such as:


70. Parasitic Infections (pinworms, roundworms, tapeworms and hookworm)


71. Untreated or partially treated bacterial infections


72. Viral infections


73. Lingering symptoms of infections


*Lifestyle


74. Lack of exercise


75. Lack of Green space exposure


76. Poor diet


77. Major life transition (move, change of school)


Metabolic or Endocrine Problems such as:



78. Hypothyroidism


79. Hyperthyroidism


80. Diabetes


81. Hypoglycemia


82. Menopause


83. Hyperbilirubinimia (Gilbert’s Disease, mildly high bilirubin, inattention?)


84. PMS


85. Post Partum Depression


*Neurological Medical Problems Including
:


86. Tourette's Syndrome


87. Autism Spectrum Disorder


88. Neurodegenerative disorders such as Alzheimer's disease


89. Temporal Lobe seizures


90. Absence Seizures


91. Post traumatic sub-clinical seizure disorder


92. Other seizure disorders


93. Neurodegenerative conditions


94. Choreiform disorder


95. Neurological infections


96. Central Nervous System or Brain trauma


97. Sensory Integration Disorders, Sensory defensiveness


98. Migraine Headaches of all varieties


99. Brain Tumors


100. Brain Cyst


101. ALS (amyotrophic lateral sclerosis)


102. Disorders of the Spine (infection, tumors, trauma)


Nutritional Problems such as:



103. Iron Deficiencies


104. Zinc Deficiencias


105. Protein Deficiencies


106. B vitamin Deficiency


107. Omega-3 Fatty Acid deficiency


108. Diets high if food colorings, flavorings and preservatives


109. Malnutrition


*Parenting Problems Such as:


110. Inadequate Parenting


111. Child abuse or neglect


112. Inconsistent expectations


113. Developmentally inappropriate parenting


114. Chaotic home environment


115. Stressful home environment


116. Cultural factors


117. Parental psychopathology


118. Parental chemical dependency


119. Parental Substance abuse


120. Exposure to Domestic Violence


Prescription Medication Problems caused by:


121. Asthma Medication


122. Allergies Medication


123. Headache Medication


124. Seizure Disorder Medication


125. Other Medication


*Psychiatric Problems such as:


126. Depression


127. Anxiety


128. Post Traumatic Stress Disorder


129. Bipolar Disorder


130. Conduct Disorder


131. Oppositional Defiance Disorder


132. Childhood Mania-Juvenile Bipolar Disorder


133. Dysthymia


134. Psychosis


135. Adjustment Disorder

    136.  Obsessive Compulsive Disorder


*Psychosocial Problems such as:


137. Abuse (sexual, physical or emotional)


138. Exposure to Traumatic Events (house fires, major motor vehicle accidents)


139. Domestic Violence


140. Loss by separation or death of a loved one


*Speech and Language Problems such as:


141. Expressive/Receptive language disorder


142. Phonological disorder


143. Dyslexia


144. Dysfluency


145. Apraxia


146. Central auditory processing disorder


*Sleep Disorders such as:


147. Insomnia


148. Breathing related sleep disorders and Sleep Apnea


149. Night Terrors


150. Delayed sleep Onset


151. Sleep Motor Restlessness (Restless Leg Syndrome, Sleep Leg Discomfort)


152. Sleep walking


153. Confusional arousals


154. Snoring


Substance Abuse Disorders


155. Illegal drug use


156. Inadvertent drug intoxication (glue sniffing)


157. Prescription drug abuse


158. Ethanol abuse

*Vision Problems such as:


159. All Vision Impairments


160. Near sightedness


161. Convergence Insufficiency


162. Visual discrimination problems

ADDITIONS:

163. Mold Neurotoxins


164. Lyme Disease


165. Ciguatera Neurotoxins


166. Adrenal Fatigue


167. Estrogen Dominance [PCOS, etc.]


168. IBS - Constipation, Diarrhea [Transit Time under 18 hr or over 24 hr]


169. Hashimoto's Autoimmune Thyroiditis


170. Parasitic Lung Diseases

171. Primary antiphospholipid antibody syndrome

172. Argininosuccinate Lyase Deficiency. Genetic disorder. Neonatal form is fatal.

173. X-Linked ichthyosis, or Steroid Sulfatase (STS) Deficiency

174. Panayiotopoulos syndrome (PS)

175.  Increased levels of Urinary phthalates

176.  DiGeorge Syndrome


It is imperative that a correct diagnosis is made before medicating a child or an adult for ADHD. Medicating a person for ADHD when the problem is actually something different is not only a waste of time; it can be dangerous as well.

The list of medical problems that are ADHD-like is long. The 175 problems included here are actually only the tip of the iceberg. Before a diagnosis of ADHD can be made, clinicians must perform a thorough history and physical to rule out other medical issues that may be causing the ADHD like symptoms. The diagnosis of ADHD can be difficult to pin down for other reasons as well. Medical problems that co-exist with ADHD can be the primary diagnosis causing the ADHD.

A good example of this would be problems that cause sleep disorders. Sleep disorder problems will cause ADHD like symptoms because fatigue and lack of sleep leads to inattention, disorganized thinking, working memory problems and a host of other psychological and medical problems but the appropriate treatment for sleep disorders is not ADHD medication. The appropriate treatment is the treatment of the underlying sleep problem.

Pediatricians, Psychiatrists, Internist, and Neurologist can make a correct diagnosis of ADHD by ruling out these medical conditions that can look like ADHD but that are NOT ADHD. The conditions list below can cause the same symptoms that are associated with ADHD. They can look like ADHD. Some of the conditions cause hyperactivity, some cause inattention, some cause impulsive behavior, some cause memory and cognitive deficits and some cause all of the above.

Based on the patient’s history and physical examination, further workup with diagnostic and/or laboratory studies as well as a specialist evaluation may be required to avoid making an ADHD misdiagnosis. This list is comprehensive and includes many ADHD-like symptom causing problems but I am certain that there are other ADHD misdiagnosis medical problems that I have left out. The list is in alphabetical order by category, not by the frequency that these conditions are mistaken for ADHD. I have placed an asterisk nest to the categories that have problems that are most commonly mistaken ADHD-like conditions.


This post was written because a reader commented here on having been diagnosed as having Gilbert's 
Disease and wondering if his fatigue and inattention could be related to that diagnosis. I set out to find a 
comprehensive list of the ‘Differential Diagnosis' of ADHD. Differential Diagnosis is a medical term that refers 
to all the other medical conditions that a physician or health care provider should consider and rule out before 
deciding on the ultimate diagnosis. I found in my research that most websites with a comprehensive differential 
diagnosis list make you pay to see the list and I thought this was preposterous.  Here it is for you, free of 
charge as always. Let me know if I missed anything.




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9 comments:

  1. Tess,
    This is an outstanding review of ADHD "appearances" - a frequent subject over at CorePsych Blog - and I applaud your deep efforts in this regard. I look forward to linking to this piece and copying with full attribution for a handout for the many folks who can't see past 'hyperactive' and 'inattentive.'

    The evolution of good care for ADHD is significantly encouraged by pieces such as this one!
    cp

    ReplyDelete
  2. Thanks Dr. Parker! Coming from you that is a huge compliment.

    Tess

    ReplyDelete
  3. Hey this is a great post, thanks alot! But you forgot to include Mold poisoning/fungi infection hahahahahaahaha

    and you should exclude ASD that's sort of an insult of how poorly you understand it. I've worked extensively and studied Aspgergs/ASD and their inattention is nowhere similar to ADHD and is not easy to confuse. I have heard though of many individuals who are diagnosed of ADHD and ASD. However although this is probaly wrong I would think that's extremely unlikely or impossible due to the fact that both syndromes involve different damaged areas of the brain and the inclusion of both would be highly unusual or detail a much more severe problem.

    ReplyDelete
  4. Hey I did include ASD.

    *Neurological Medical Problems Including:
    86. Tourette's Syndrome
    87. Autism Spectrum Disorder

    Thanks for your comments!

    ReplyDelete
  5. Tess - really helpful post. thanks!

    David

    ReplyDelete
  6. Oddly enough this article gives some hope and is comforting that there is more to ADHD than just being linked with a disorder that is primarily linked to the brain and helps dispel the fear of isolation due to social stigma involved in neurological and brain disorders.

    ReplyDelete
  7. I couldn't agree more. There are lots of cases out there that most of us think is ADHD. If you feel like your children have that kind of disease, you should probably ask your doctor first.

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    ReplyDelete
  8. Thank you for the information.
    this will realy helpfull for me

    Medical Transcription Company

    ReplyDelete
  9. GREAT list, Tess. I found you thru cp's CorePsych Post and have backlinked this page to an article on my main blog: Differential Diagnosis (part 2)

    I'll be back!!

    Madelyn Griffith-Haynie, SCAC, MCC - (blogging at ADDandSoMuchMore and on ADDerWorld - dot com!)
    "It takes a village to transform a world!"

    ReplyDelete

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