Dr Andrew Solomon Details Conditions Commonly Misdiagnosed as MS

There are numerous conditions, including many rare and difficult to recognize disorders, which can be mistaken for MS, said Andrew Solomon, MD, associate professor of neurological sciences and division chief of multiple sclerosis at Larner College of Medicine, The University of Vermont, Burlington, Vermont.

What are some of the conditions that are commonly misdiagnosed as being MS?

As neurologists, in our training we come to understand that there's this very long list or broad differential diagnosis for MS–there are many disorders, including many rare and difficult to recognize disorders that can be mistaken for MS.

So, while there's many rare and challenging to diagnose disorders that can be mistaken for MS, some of the recent data that we've seen around misdiagnosis and differential diagnosis of MS in referral centers seems to suggest that many common disorders are frequently mistaken for MS. Some of those disorders include things like migraine, small vessel ischemic disease, which is a manifestation often of high blood pressure accompanied by some neurologic symptoms. Functional neurologic disorders may be frequently mistaken for MS, and then there's a number of demyelinating conditions now that we recognize as distinct from MS–neuromyelitis optica spectrum disorder, myelin oligodendrocytes, glycoprotein myelitis, and optic neuritis associated disorders can be easily mistaken for MS.

By virtue of some of these very common disorders being mistaken for MS, it seems like part of the problem is our diagnostic criteria may not be applied in these situations as rigorously as it should. It seems like there may be either misapplication or misunderstanding of different elements of the McDonald criteria that could lead to misdiagnosis of some of these common disorders for MS.
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