The haematological profile of patients with multiple sclerosis. The hallmark of ms is symptomatic episodes that occur months or ye. Pdf diagnosis of multiple sclerosis ms requires exclusion of diseases that could better explain the clinical and paraclinical findings. Initial evaluations for multiple sclerosis in a university multiple sclerosis center. Recent research developments have helped improve the accuracy of multiple sclerosis diagnosis, especially with regard to. The patients complaints of progressive numbness over that past year with the occurrence of a fall while running combined with her age and gender indicates the possibility of this diagnosis. Other tests include visual evoked potentials vep and analysis of spinal fluid taken by lumbar puncture. In the absence of pathognomonic clinical features or a definitive laboratory test, multiple sclerosis ms remains ultimately a diagnosis of exclusion. The international panel on the diagnosis of multiple sclerosis released these criteria. Neurologic differential diagnosis, 2nd edition, by mark mumenthaler, translated and annotated by otto appenzeller, 1992, georg thieme verlag, stuttgartnew york, 178 pages, dm68. The most important tools are the medical history, a careful and thorough neurologic exam, and magnetic resonance imaging mri. One of the more recent innovations in diagnosing ms is a tool called optical coherence tomography oct. Early differential diagnosis of multiple sclerosis using a. Multiple sclerosis ms is an immunemediated inflammatory disease that attacks myelinated axons in the central nervous system, destroying the myelin and the axon in variable degrees and producing significant physical disability within 2025 years in more than 30% of patients.
A clinical approach to the differential diagnosis of multiple sclerosis. It is also the most common cause of neurological disability in young adults. Myelin damage and the nervous system mayo clinic, 2017 rationale. Classification, diagnosis, and differential diagnosis of. Differential diagnosis of multiple sclerosis sciencedirect. Systemic sclerosis ssc is a systemic connective tissue disease. Dec 16, 2016 multiple sclerosis ms and neuromyelitis optica nmo are both demyelinating disorders. The common symptoms of multiple sclerosis include fatigue, muscle weakness, blurred vision, abnormal sensation, difficulty in. Differential diagnosis of suspected multiple sclerosis 1. The article mainly tackles the problem of different diagnosis criteria between acute disseminated encephalomyelitis adem and multiple sclerosis ms during the acute phase of the first episode in a population aged 15 years and older. Nov 17, 2010 differential diagnosis of suspected multiple sclerosis 1. Psychiatric diseases are mistaken for multiple sclerosis more. Diagnosis multiple sclerosis about diagnosis multiple.
Pdf the diagnosis of multiple sclerosis ms relies on the occurrence of characteristic symptoms, on the patients history and on the correct. Diagnosis is made through a combination of the clinical history, neurologic examination, magnetic resonance imaging and the exclusion of other diagnostic. Differential diagnosis of suspected multiple sclerosis sage journals. Background intrathecal igg synthesis itgs, in conjunction with magnetic resonance imaging, can help in the early diagnosis of multiple sclerosis ms. Background and objectivesdiagnosis of multiple sclerosis ms requires. Differential diagnosis of multiple sclerosisfebruary 22, 1999 1 homework 5. Therefore, when damage in the cns is big enough to be seen. Multiple sclerosis an autoimmune condition that affect multiple organ systems and should not be confused with ms a chest xray may show granulomatous disease of the lungs meningeal enhancement is seen in patients with cns involvement oligoclonal bands and igg are raised in csf of patients with sarcoidosis. Multiple sclerosis ms is the most common permanently disabling disorder of the central nervous system in young adults. Multiple sclerosis ms and neuromyelitis optica nmo are both demyelinating disorders.
Characteristics of systemic sclerosis include essential vasomotor disturbances. Knowledge about the differential diagnosis of multiple sclerosis is important for a physiotherapist in order to distinguish multiple sclerosis from other conditions that present with almost similar clinical features. As shown in this slide, typical locations of ms lesions include juxtacorticalcortical yellow arrows and periventricular red arrows white matter, as well as the white matter of the brainstem, cerebellum, and spinal cord. Resources diagnosis and differential diagnosis of multiple sclerosis. Recent research developments have helped improve the accuracy of multiple sclerosis diagnosis, especially with regard to differentiating. Multiple sclerosis is one of those diseases, the mysterious existence of which is something that experts fail to understand till today. Carmosino mj, brousseau km, arciniegas db, corboy jr. Differential diagnoses multiple sclerosis case study. In this video, expert neurologists describe the differential diagnosis process that is used to exclude other neurological conditions that can mimic ms. The differential diagnoses can be ruled out by blood tests, mri scans, ctscans, spinal taps etc. A chest xray may show granulomatous disease of the lungs, and meningeal enhancement is seen in patients with cns involvement. The diagnosis of multiple sclerosis is made by differential diagnosis. During a lumbar puncture spinal tap procedure, you. In most cases, the diagnosis of multiple sclerosis ms presents few difficulties.
N2 the diagnostic criteria for multiple sclerosis ms rely on clinical, paraclinical, and radiographic findings of limited specificity. Occasionally, however, a rogue erythrocyte sedimentation rate esr, an atypical or normal mri scan, or an unexpected symptom. Differential diagnosis of multiple sclerosis 884 words. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. T1 a clinical approach to the differential diagnosis of multiple sclerosis. Guidance on the differential diagnosis process when ms is under consideration will enhance diagnostic accuracy and precision. A clinical approach to the differential diagnosis of. Neuromyelitis optica spectrum disorder nmosd acute disseminated encephalomyelitis adem. Symptoms, disease patterns, diagnosis, prognosis, treatment, and research efforts. The diagnosis of multiple sclerosis ms is based on demonstrating evidence of inflammatorydemyelinating injury within the central nervous system that is disseminated in both time and space. Misdiagnosis has been common because many symptoms relating to these 2 disorders overlap.
The differential diagnosis of multiple sclerosis using. The differential diagnosis of multiple sclerosis journal. Multiple sclerosis ms is the most common demyelinating disease of the central nervous system cns and it has a genetic susceptibility noseworthy et al. The ideal diagnosis schema would be able to determine for any given subject, if he will develop ms, at any point in his life, and when. Differential diagnosis ms mimics autoimmuneinflammatory conditions. The patient presents with the chief complaint of frequent episodes of weakness, and a tingling sensation in different areas of her body. The majority of patients with ms will have muscle weakness in their extremities as well as paresthesias. Differential diagnosis of multiple sclerosis 2092 words.
Pdf differential diagnosis of suspected multiple sclerosis. Relapsing remitting ms is the most common type, and typical symptoms. Differential diagnosis is the process of finding the cause of symptoms by ruling out other possible causes. Your doctor is likely to start with a thorough medical history and examination. In order to reach a diagnosis, a neurologist must rule out a. The diagnosis of ms is a clinical diagnosis, meaning that the. Pdf download for differential diagnosis of suspected multiple.
Discussion multiple sclerosis usually starts with an acute episode of neurological disturbance, termed a clinically isolated syndrome, followed by an illness phase punctuated by relapses and remissions which may transition after 10 years to a phase of. Focus multiple sclerosis diagnosis, management and prognosis 950 reprinted from australian family physician vol. The diagnostic criteria for multiple sclerosis ms have been continuously evolved since 1950s, and gained speed parallel to the development of detailed. Though the cause of this condition still remains unknown, there are other facts and information that can help the multiple sclerosis diagnosis. Differential diagnosis of multiple sclerosis neurology. This relied on evidence of at least two relapses typical of multiple sclerosis and evidence of involvement of white matter in more than one site in the central nervous system, the concept of lesions scattered in time and space. Multiple sclerosis diagnosis can only be made when there is proof of lesions disseminated in time and in space. The first requirement for a diagnosis of ms is that the presenting signs and symptoms be consistent with demyelinating disease.
Recently, we developed a new oligoclonal igg band ocgb test for itgs detection that is more sensitive and easier to interpret than previously described methods. Pdf diagnosis and differential diagnosis of multiple. Paris new proposed revisions to the mcdonald diagnostic criteria for multiple sclerosis ms should enable the disease to be diagnosed earlier in. Additionally, ms diagnostic criteria have emphasized that alternative explanation for the clinical presentation must be considered and excluded before a diagnosis.
Multiple sclerosis hopes to illuminate the disease and separate fact from fiction for the benefit of all. Clinical evidence of lesions disseminated in time and space, backed up by. Sarcoidosis and sjogrens syndrome may show lesions on mri that resemble those found in multiple sclerosis. Multiple sclerosis diagnosis and treatment mayo clinic. Since the early 1980s the poser criteria was used to classify multiple sclerosis. Differential diagnosis for multiple sclerosis youtube. Our purpose is to develop a clinical decision support system to classify the patients diagnostics based on features gathered from magnetic resonance ima. Differential diagnosis of multiple sclerosis ce information.
Differential diagnosis has important clinical implications because ms and nmo respond to different treatments. Here is a list of some of the differential diagnoses for multiple sclerosis in no particular order some of these are less severe than ms and some are more so, many are very rare. Clinical evidence of lesions disseminated in time and space, backed up by magnetic resonance imaging mri andor spinal fluid changes, commonly leave neither room nor reason for doubt. Pdf diagnosis and differential diagnosis of multiple sclerosis. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Mr appearance and correlation with clinical parameters. Multiple sclerosis must be differentiated from other diseases that can mimic this disease clinically or radiologically such as systemic lupus erythematosis, sjogrens syndrome, vasculitis, neurobehcets disease, sarcoidosis, antiphospholipid hughes syndrome, susac syndrome, lyme disease, syphilis, htlv1 infection, hivrelated. Unraveling the mystery of ms differential diagnosis. Case study multiple sclerosis villanova university. Here, we will journey through the disease itself, through symptoms of multiple sclerosis, alternative. New ms diagnostic criteria will allow earlier diagnosis.
Racgp multiple sclerosis diagnosis, management and. Diagnosis and differential diagnosis of multiple sclerosis. This article summarises the diagnosis, management and prognosis of multiple sclerosis. Multiple sclerosis, mcdonalds criteria, diagnostic markers, ms differential diagnosis, inflammatory demyelinating disorders introduction multiple sclerosis ms is an acquired idiopathic, inflammatory demyelinating disorder of the central nervous system cns in which the myelin sheath is disrupted due to genetic and environmental. Apr 30, 2020 multiple sclerosis ms is an immunemediated inflammatory disease that attacks myelinated axons in the central nervous system, destroying the myelin and the axon in variable degrees and producing significant physical disability within 2025 years in more than 30% of patients. Development of this content was partially supported by a grant from hrsa d09hp189980100.
A diagnosis of multiple sclerosis ms requires not only the demonstration of cns lesions disseminated in time and space but also the active exclusion of alternative diagnoses. These are autoimmune conditions that affect multiple organ systems and should not be confused with ms. Jan 31, 2014 in this video, expert neurologists describe the differential diagnosis process that is used to exclude other neurological conditions that can mimic ms. This article will discuss the diagnosis of multiple sclerosis ms, with particular attention to differentiating it from other diseases that can mimic it. The article mainly tackles the problem of different diagnosis criteria between acute disseminated encephalomyelitis adem and multiple sclerosis ms during the acute phase of the first episode in a population aged 15.
I go to pt 2 days a week when my insurance company will pay for it. Recent findings an international panel of multiple sclerosis experts, the ms phenotype group, recently revised the multiple sclerosis phenotypic classifications and published their recommendations in 2014. This site is intended to be a community for those of us living with multiple sclerosis as well as those that support us. Differential diagnosis national multiple sclerosis society. Classification, diagnosis, and differential diagnosis of multiple sclerosis. Differential diagnosis of multiple sclerosis due wednesday, 3399 1. There is no one test that on its own will on its own show a neurologist that someone has ms. Accurate diagnosis is increasingly important with available disease modifying therapy. Differential diagnosis of multiple sclerosis 884 words 4 pages. Differential diagnosis ms mimics the first requirement for a diagnosis of ms is that the presenting signs and symptoms be consistent with demyelinating disease.
268 1109 26 1315 309 1357 673 1558 257 1181 222 1007 326 315 956 850 994 989 425 411 804 442 580 1479 931 993 169 765 1079 1142 324 188 885 599 607 28 870 412 1296 651 54 1261 1431