These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
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.
It is also known as neuromyelitis optica (NMO) or Devic's disease. Some of its symptoms are similar to the symptoms of multiple sclerosis, so it may be misdiagnosed as such.
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.
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.
What Does MS Feels Like? A lack of feeling or a pins-and-needles sensation can be the first sign of nerve damage from MS. It usually happens in your face, arms, or legs, and on one side of your body. It tends to go away on its own.
Blood Tests: Currently, there are no definitive blood tests for diagnosing MS, but they can be used to rule out other conditions that may mimic MS symptoms, including Lyme disease, collagen-vascular diseases, rare hereditary disorders and acquired immune deficiency syndrome (AIDS).
Some of the most common mimics include migraine and chronic cerebrovascular disease, according to Dr Schiess. Vasculitic autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjögren's syndrome can also result in white matter abnormalities on MRI.
False Results
MRI leads to false negatives—i.e., results that say MS is not present when it really is—in about 5% of MS cases. Other times, age-related damage or other conditions (migraine, brain trauma) look like MS lesions. This produces false positives, or results that indicate MS when it's not there.
People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
Abnormal sensations can be a common initial symptom of MS. This often takes the form of numbness or tingling in different parts of your body, such as the arms, legs or trunk, which typically spreads out over a few days.
But despite some similarities, “for the most part, there is no mistaking symptoms of MS with fibromyalgia,” says Philip Cohen, MD, a rheumatologist, professor of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University in Philadelphia.
Some people with MS feel that they developed MS as a direct result of some stressful event or trauma. The evidence on this connection is mixed. Some studies do see an effect whilst others don't.
The diagnosis of MS cannot be made solely on the basis of MRI because there are other diseases that cause lesions in the CNS that look like those caused by MS. And even people without any disease — particularly the elderly — can have spots on the brain that are similar to those seen in MS.
An MRI scan can detect MS activity early on , sometimes before an individual experiences any worsening symptoms.
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.
Dawson's finger is a type of brain lesion common to people who have MS. These lesions develop on the ventricles, or fluid-filled spaces in the brain. Dawson's finger lesions can help a doctor diagnose multiple sclerosis (MS) when other symptoms, such as difficulties with movement or thought processes, accompany them.
There are rare cases where someone can have MS but their MRI will look clear. This happens. That doesn't mean they can't get a diagnosis of multiple sclerosis, but it does make it significantly more difficult.
Possible Causes
Brain tumors (including cancer). Congenital disorders (conditions you have at birth) and metabolic disorders. Degenerative brain diseases (especially age-related ones), such as Alzheimer's disease, Lewy body dementia, Multiple system atrophy, and Parkinson's disease.
Neuropathic pain happens from “short circuiting” of the nerves that carry signals from the brain to the body because of damage from MS. These pain sensations feel like burning, stabbing, sharp and squeezing sensations.
Other causes
Other types of demyelinating disease and their causes include: Optic neuritis — inflammation of the optic nerve in one or both eyes. Neuromyelitis optica spectrum disorder (NMOSD) — inflammation and demyelination of the central nervous system, especially of the optic nerve and spinal cord.
Your doctor will refer you to a neurologist. They will examine you to check how different parts of your nervous system are working. A combination of tests is used to diagnose MS. The best test is an MRI of your brain and spinal cord to detect areas of damage.
Inflammation in a myelinated portion of the nervous system is the mainstay of multiple sclerosis (MS). Elevation of inflammatory markers such as procalcitonin, ESR and hs-CRP is suspected to occur in MS patients.
Characteristics of the MS gait pattern
You may walk more slowly, with shorter steps. You may lack in confidence when you walk – leading to hesitation and stumbling. You might feel unsteady when turning or walking. You might find placing your foot on the ground difficult.