One study conducted in four academic MS centers revealed over 50% of patients carried a misdiagnosis for at least 3 years, 70% had received disease-modifying therapy (DMTs), and 31% experienced unnecessary morbidity as a direct result (2).
Some conditions that doctors may commonly misdiagnose as MS include migraine, RIS, spondylopathy, and neuropathy. To accurately diagnose MS, doctors must rule out conditions with similar symptoms and look for signs and symptoms specific to MS. As such, the process of diagnosing MS may be lengthy and complex.
The signs and symptoms of multiple sclerosis (MS) overlap with many other conditions. This makes misdiagnosis common. Further, MS isn't fully understood, which makes differential diagnosis (a way of ruling out or confirming other, similar conditions) a complicated and time-consuming process.
An MRI scanner uses a strong magnetic field to create a detailed image of inside your brain and spinal cord. It's very accurate and can pinpoint the exact location and size of any inflammation, damage or scarring (lesions). MRI scans confirm a diagnosis in over 90 per cent of people with MS.
Spinal tap (lumbar puncture), in which a small sample of cerebrospinal fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS . A spinal tap can also help rule out infections and other conditions with symptoms like MS .
Misinterpretation of abnormal MRI findings is a frequent contributor to misdiagnosis of MS. One study found that only 11% of patients who were referred to a MS subspecialty center based primarily on an abnormal MRI were subsequently diagnosed with MS.
Researchers Study MS Misdiagnosis
They found that 18% of patients who were diagnosed with MS by a referring clinician did not actually have the disease.
MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.
Hypoxic-ischemic vasculopathy, specially small-vessel disease, inflammatory disorders, vasculitis, and non-MS idiopathic inflammatory disorders, as well as some toxic, metabolic, and infectious disorders, may present mimicking MS on MR examinations and should be included in the differential diagnosis of MS-like lesions ...
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including lupus erythematosus, Sjogren's syndrome, vitamin and mineral deficiencies, some infections and rare hereditary diseases.
As well as your mental wellbeing, anxiety can also manifest with physical symptoms, which may be similar to some MS symptoms, such as: Increase in fatigue symptoms. Disrupted sleep and appetite.
Answer. There are a number of symptoms that can occur in both ME/CFS and MS – fatigue, cognitive dysfunction, pins and needles/sensory disturbances, poor balance and co-ordination, pain and problems with temperature control – as well as other symptoms that are not common to both conditions.
Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI.
An “average” number of lesions on the initial brain MRI is between 10 and 15. However, even a few lesions are considered significant because even this small number of spots allows us to predict a diagnosis of MS and start treatment.
Diagnosing MS is complicated because no single test can positively diagnose it. Other possible causes of your symptoms may need to be ruled out first. It may also not be possible to confirm a diagnosis if you have had only 1 attack of MS-like symptoms.
Several autoimmune diseases have symptoms that mimic those of MS. An autoimmune disease is one in which your immune system attacks your body's tissues and organs. One of the more common autoimmune conditions is lupus. It causes inflammation that affects your skin, joints, brain, kidneys, heart, blood cells, and lungs.
T-2 scans show the total number of old and new lesions in the brain from the onset of MS. New MS lesions appear as bright spots on a T-2 scan. These are also known as hyperintense lesions. Typical lesions that appear on a T-2 scan are oval in shape.
MOGAD is a rarer condition that is similar to MS in some ways, but has more specific symptoms, such as ataxia, myelitis, and encephalopathy.
The tests could still be inconclusive
Not necessarily. If you have MS, you still might not have tested positive in all the MS tests.
Here's where MS (typically) starts
You may experience eye pain, blurred vision and headache. It often occurs on one side and can eventually lead to partial or total vision loss. Spinal cord inflammation, or what's called partial transverse myelitis, is the second most common symptom Shoemaker typically sees.
The early signs and symptoms of MS can be the same for women and men. One of the more obvious first signs of MS is a problem with vision, known as optic neuritis. This is often because it's a more concrete symptom as opposed to vaguer neurological symptoms like numbness and tingling.
Key points
Others may lose the ability to see clearly, write, speak, or walk. Early symptoms can include vision problems, trouble walking, and tingling feelings. MS affects people differently. But common problems are trouble with movement and thinking, and bowel and bladder incontinence.
Sometimes an MRI reviewed by a radiologist can provide enough evidence to make a diagnosis. But in the case of MS, it takes a combination of the MRI with the patient's clinical symptoms, history, and neurological examination to make the diagnosis.