Common Clinical and Imaging Conditions Misdiagnosed as Multiple Sclerosis A Current Approach to the Differential Diagnosis of Multiple Sclerosis

The number of cases with multiple sclerosis is increasing, so is the number of misdiagnosed cases as MS. One major source of misdiagnosis is misinterpretation of nonspecific clinical and imaging findings and misapplication of MS diagnostic criteria resulting in an overdiagnosis of MS. Because nonspecific white matter abnormalities on brain MRI and other imaging findings may mimic MS, as well as MS-nonspecific lesions that are seen in people with MS, neurologists should be aware of all possibilities and should be able to interpret the clinical and MRI findings well and by themselves. The differential diagnosis of MS includes MS variants and inflammatory astrocytopathies and other atypical inflammatory-demyelinating syndromes, as well-as a number of systemic diseases with CNS involvement. A detailed history, a through neurologic examination, and cerebrospinal fluid study are essential for MS diagnosis, and MRI is one other tool that is most often confirmatory, but may cause confusion at times too.