Follow up on my young patient - he’s on a low-therapeutic dose of the specific medication for the disorder I believe he has. He’s responding just as he should, with significant improvements in his symptoms, which follow the expected timing of duration of action of the drug. This is diagnostic since this medication doesn’t work for anything else.
He’s made an appointment to see the specialist near me that was so helpful and validating on the phone, even though he’ll have to pay out of pocket as she is not part of his HMO. Meanwhile I am carefully adjusting his dose.
I’m still completely baffled as to how THREE neurologists (and a neurology resident) could have missed this diagnosis. It has followed the typical path, I could provoke the symptoms with the typical bedside test (which none of the neurologists bothered to perform) and he’s responding to the medication!
I’m so glad he happened to know my son so that I could help him. And so glad the local specialist took my call.