Multiple sclerosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

• Overview

Differentiating multiple sclerosis from other diseases

Multiple sclerosis must be differentiated from other diseases that can mimic this disease clinically or radiologically such as:

Inflammatory/autoimmune conditions:

• systemic lupus erythematosus: Systemic lupus erythromatosus can cause neurological manifestations such as seizures, movement disorders, transverse myelitis, cranial and peripheral neuropathies and optic nerve involvement. In the brain MRI of SLE patients there are evidences of atrophy and subcortical white matter lesions. SLE is diagnosed based on systemic manifestations, present of oligoclonal bands and IgG in CSF and high titer of antinuclear antibodies.
• Sjögren’s syndrome: Sjogren disease can cause neurological manifestations including cerebral vasculitis, myopathy, transvers myelitis and acute optic neuropathy. There are evidence of oligoclonal band and increased IgG in CSF and white matter lesions in MRI. Sicca syndrome, rheumatic manifestation and high titers of ANA,SSRo and SS-La will confirm the diagnosis..
• Vasculitis:
• Behçet’s disease:
• sarcoidosis:

• Antiphospholipid (Hughes) Syndrome
• Primary Angiitis of the CNS
• Susac Syndrome

Infections:

• Lyme disease:
• syphilis:
• Progressive multifocal leukoencephalopathy:
• HTLV-1 infection:
• Herpes zoster:

Metabolic and genetic disorders:

• Vitamin B12 deficiency:
• Lysosomal disorders:
• Adrenoleukodystrophy:
• Mitochondrial disorders:
• Clinically defined genetic disorders: