Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-30T15:21:59.823Z Has data issue: false hasContentIssue false

Chapter 5 - Differential Diagnosis

Published online by Cambridge University Press:  10 February 2021

Carlos A. Perez
Affiliation:
University of Texas, Houston
Andrew Smith
Affiliation:
OhioHealth Riverside Methodist Hospital in Columbus, Ohio, USA
Flavia Nelson
Affiliation:
University of Minnesota, Minneapolis
Get access

Summary

Despite recent refinements in the diagnostic criteria, multiple sclerosis (MS) remains a challenging diagnosis. Several acquired and inherited disorders can mimic MS both clinically and radiographically, which may further complicate the diagnostic process. This chapter focuses on the most common diseases that mimic MS (“MS mimics”), the most relevant clinical and diagnostic characteristics suggestive of an alternative diagnosis, and the best diagnostic workup for the exclusion of similar conditions. A discussion of specific magnetic resonance imaging (MRI) features that may help distinguish MS from its mimics is presented in Chapter 6.

Type
Chapter
Information
Multiple Sclerosis
A Practical Manual for Hospital and Outpatient Care
, pp. 59 - 80
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tornes, L, Conway, B, Sheremata, W. Multiple sclerosis and the cerebellum. Neurol Clin. 2014;32:957–77.CrossRefGoogle ScholarPubMed
Baumann, M, Grams, A, Djurdjevic, T, et al. MRI of the first event in pediatric acquired demyelinating syndromes with antibodies to myelin oligodendrocyte glycoprotein. J Neurol. 2018;265(4):845–55. doi:10.1007/s00415-018-8781-3Google Scholar
Renowden, S. Imaging in multiple sclerosis and related disorders. Pract Neurol. 2014;14(5):120. doi:10.1136/practneurol-2014-000856Google Scholar
Takewaki, D, Lin, Y, Sato, W, et al. Normal brain imaging accompanies neuroimmunologically justified, autoimmune encephalomyelitis. Neurol Neuroimmunol Neuroinflammation. 2018;5:e456. doi:10.1212/NXI.0000000000000456Google Scholar
Adoni, T. Anti-MOG syndrome: a road to be paved. Arq Neuropsiquiatr. 2017;75(10):685–6. doi:10.1212/NXI.0000000000000081Google Scholar
Nakamura, Y, Nakajima, H, Tani, H, et al. Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report. BMC Neurol. 2017;17(1):76. doi:10.1186/s12883-017-0858-6CrossRefGoogle ScholarPubMed
Wingerchuk, DM. Immune-mediated myelopathies. Continuum (Minneap Minn). 2018;24(2):497–22. doi:10.1212/CON.0000000000000582Google ScholarPubMed
Gelfand, JM.Multiple Sclerosis: Diagnosis, Differential Diagnosis, and Clinical Presentation. Vol 122. Goodin, DS, ed. Amsterdam: Elsevier; 2014. doi:10.1016/B978-0-444-52001-2.00011-X.Google Scholar
Bou-Haidar, P, Peduto, A, Karunaratne, N. Differential diagnosis of T2 hyperintense spinal cord lesions: Part B. J Med Imaging Radiat Oncol. 2009;53(2):152–9. doi:10.1111/j.1754-9485.2009.02067.xCrossRefGoogle ScholarPubMed
Brownlee, WJ, Hardy, TA, Fazekas, F, Miller, DH. Diagnosis of multiple sclerosis: progress and challenges. Lancet. 2017;389:1336–46. doi:10.1016/S0140-6736(16)30959-XCrossRefGoogle ScholarPubMed
Rostasy, K, Bajer-Kornek, B, Venkateswaran, S, et al. Differential diagnosis and evaluation in pediatric inflammatory demyelinating disorders. Neurology. 2016;87(9 suppl 2):S28–37.CrossRefGoogle ScholarPubMed
Balashov, K. Imaging of central nervous system demyelinating disorders. Continuum (Minneap Minn). 2016;22(5):1613–35. doi:10.1212/CON.0000000000000373Google ScholarPubMed
Thompson, AJ, Baranzini, SE, Geurts, J, et al. Multiple sclerosis. Lancet Neurol. 2018;391:1622–36. doi:10.1016/B978-0-7234-3748-2.00015-3Google ScholarPubMed
Yu, S, Ran, Y, Dong, Z, et al. Anti-NMDAR encephalitis followed by seropositive neuromyelitis optica spectrum disorder: a case report and literature review. Clin Neurol Neurosurg. 2017;155:7582. doi:10.1016/j.clineuro.2017.02.016Google Scholar
Pérez, CA, Agyei, P, Gogia, B, et al. Overlapping autoimmune syndrome: a case of concomitant anti-NMDAR encephalitis and myelin oligodendrocyte glycoprotein (MOG) antibody disease. J Neuroimmunol. 2020;339. doi:10.1016/j.jneuroim.2019.577124CrossRefGoogle ScholarPubMed
Baheerathan, A, Brownlee, WJ, Chard, DT, et al. Antecedent anti-NMDA receptor encephalitis in two patients with multiple sclerosis. Mult Scler Relat Disord. 2017;12:20–2. doi:10.1016/j.msard.2016.12.009Google Scholar
Sharma, A, Kaur, M, Paul, M. Morvan’s syndrome with anti contactin associated protein like 2-voltage gated potassium channel antibody presenting with syndrome of inappropriate antidiuretic hormone secretion. J Neurosci Rural Pract. 2016;7(4):577–9. doi:10.4103/0976-3147.188638Google Scholar
Nosadini, M, Toldo, I, Tascini, B, et al. LGI1 and CASPR2 autoimmunity in children: systematic literature review and report of a young girl with Morvan syndrome. J Neuroimmunol. 2019;335:577008. doi:10.1016/j.jneuroim.2019.577008CrossRefGoogle Scholar
Kleopa, KA. Autoimmune channelopathies of the nervous system. Curr Neuropharmacol. 2011;9(3):458–67. doi:10.2174/157015911796557966CrossRefGoogle ScholarPubMed
Huang, K, Luo, YB, Yang, H. Autoimmune channelopathies at neuromuscular junction. Front Neurol. 2019;10:116. doi:10.3389/fneur.2019.00516CrossRefGoogle ScholarPubMed
Bien, CI, Nehls, F, Kollmar, R, et al. Identification of adenylate kinase 5 antibodies during routine diagnostics in a tissue-based assay: three new cases and a review of the literature. J Neuroimmunol. 2019;334. doi:10.1016/j.jneuroim.2019.576975CrossRefGoogle Scholar
Lancaster, E, Dalmau, J. Neuronal autoantigens: pathogenesis, associated disorders and antibody testing. Nat Rev Neurol. 2012;8(7):380–90. doi:10.1038/nrneurol.2012.99CrossRefGoogle ScholarPubMed
Hara, M, Ariño, H, Petit-Pedrol, M, et al. DPPX antibody-associated encephalitis: main syndrome and antibody effects. Neurology. 2017;88(14):1340.CrossRefGoogle ScholarPubMed
Abrantes, F, Toso, FF, Povoas, OG, Hoftberger, R. Autoimmune encephalitis: a review of diagnosis and treatment. Arq Neuropsiquiatr. 2017:41–9.CrossRefGoogle Scholar
Dale, RC. Autoimmune encephalitis: overview of clinical recognition, autoantibody diagnostic markers, and treatment of autoimmune encephalitis. In: Yamanouchi, H, Moshé, SL, Okumura, A, eds. Acute Encephalopathy and Encephalitis in Infancy and Its Related Disorders. Nagakute, Japan: Elsevier; 2017:123–32.Google Scholar
Olek, MJ. Differential diagnosis, clinical features, and prognosis of multiple sclerosis. Curr Clin Neurol Mult Scler. 2005:15–53.CrossRefGoogle Scholar
Marcus, JF, Waubant, EL. Updates on clinically isolated syndrome and diagnostic criteria for multiple sclerosis. Neurohospitalist. 2013;3(2):6580. doi:10.1177/1941874412457183CrossRefGoogle ScholarPubMed
Palace, J. Making the diagnosis of multiple sclerosis. J Neurol Neurosurg Psychiatry. 2001;71(suppl II):ii3–8. www.ncbi.nlm.nih.gov/pubmed/16400830.Google ScholarPubMed
Stone, J, Smyth, R, Carson, A, et al. Systematic review of misdiagnosis of conversion symptoms and “hysteria.” Br Med J. 2005;331(7523):989–91. doi:10.1136/bmj.38628.466898.55CrossRefGoogle ScholarPubMed
Chen, JJ, Carletti, F, Young, V, Mckean, D, Quaghebeur, G. MRI differential diagnosis of suspected multiple sclerosis. Clin Radiol. 2016;71(9):815–27. doi:10.1016/j.crad.2016.05.010CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×