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.[1]
- 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.[2]
- Vasculitis: Wegner’s granulomatosis and polyarteritis nodosa are sometimes categorized as a differential diagnosis of MS, but the most common vasculitis which can mimic MS is isolated angitis of the central nervous system (IACNS).[3]
- 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:
CNS lymphoma
spinal diseases
References
- ↑ Barned S, Goodman AD, Mattson DH (1995). "Frequency of anti-nuclear antibodies in multiple sclerosis". Neurology. 45 (2): 384–5. PMID 7854544.
- ↑ Alexander EL, Malinow K, Lejewski JE, Jerdan MS, Provost TT, Alexander GE (1986). "Primary Sjögren's syndrome with central nervous system disease mimicking multiple sclerosis". Ann. Intern. Med. 104 (3): 323–30. PMID 3946977.
- ↑ Calabrese LH, Furlan AJ, Gragg LA, Ropos TJ (1992). "Primary angiitis of the central nervous system: diagnostic criteria and clinical approach". Cleve Clin J Med. 59 (3): 293–306. PMID 1516217.