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A Clinical Approach to the Differential Diagnosis of Multiple Sclerosis

  • Demyelinating Disorders (DN Bourdette and M Cameron, Section Editors)
  • Published:
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Abstract

The diagnostic criteria for multiple sclerosis (MS) rely on clinical, paraclinical, and radiographic findings of limited specificity. Many disorders mimic MS, and the decision of when to investigate an alternative diagnosis can be challenging. Reliance on extensive ancillary testing to exclude potential mimics, however, is unnecessary in most cases. Rather, recognition and rigorous interpretation of “classic” clinical and radiographic features of MS are often sufficient to establish the diagnosis. Misinterpretation of the clinical and radiographic diagnostic criteria for MS in the setting of more common diseases and syndromes and a lack of vigilance for “red flags” are important contributors to misdiagnosis. A clinical framework for the differential diagnosis of MS that emphasizes phenotypes atypical for MS and suggests diseases or syndromes in which they more commonly occur may be an important diagnostic guide for clinicians in contemporary practice.

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Conflict of Interest

Michel Toledano declares no conflict of interest.

Brian G. Weinshenker is a board member of MedImmune, Novartis, Mitsubishi, and Biogen-Idec; has received consultancy fees from Novartis, Chugal, and Chord Therapeutics; and has received a grant from the Guthy Jackson Charitable Foundation. Dr. Weinshenker also has a patent with Mayo Medical Ventures, has received royalties from RIS Ltd. and Oxford University and paid travel accommodations from Alexion Pharmaceuticals.

Andrew J. Solomon has received a grant from the National Multiple Sclerosis Society.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Michel Toledano & Brian G. Weinshenker

  2. Department of Neurological Sciences, University of Vermont College of Medicine, 1 South Prospect St, Burlington, VT, 05401, USA

    Andrew J. Solomon

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  1. Michel Toledano
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Correspondence to Andrew J. Solomon.

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This article is part of the Topical Collection on Demyelinating Disorders

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Toledano, M., Weinshenker, B.G. & Solomon, A.J. A Clinical Approach to the Differential Diagnosis of Multiple Sclerosis. Curr Neurol Neurosci Rep 15, 57 (2015). https://doi.org/10.1007/s11910-015-0576-7

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