Differential diagnosis of suspected multiple sclerosis: a consensus approach
By David H. Miller, B. Weinshenker, M. Filippi, B. Banwell, Jeffrey A. Cohen, M. Freedman, S. Galetta, M. Hutchinson, R. Johnson, L. Kappos and 8 more. Multiple Sclerosis, 2008
659 citations recorded by the source corpus.
Background and objectives Diagnosis of multiple sclerosis (MS) requires exclusion of diseases that could better explain the clinical and paraclinical findings. A systematic process for exclusion of alternative diagnoses has not been defined. An International Panel of MS experts developed consensus perspectives on MS differential diagnosis. Methods Using available literature and consensus, we developed guidelines for MS differential diagnosis, focusing on exclusion of potential MS mimics, diagnosis of common initial isolated clinical syndromes, and differentiating between MS and non-MS idiopathic inflammatory demyelinating diseases. Results We present recommendations for 1) clinical and paraclinical red flags suggesting alternative diagnoses to MS; 2) more precise definition of “clinically isolated syndromes” (CIS), often the first presentations of MS or its alternatives; 3) algorithms for diagnosis of three common CISs related to MS in the optic nerves, brainstem, and spinal cord; and 4) a classification scheme and diagnosis criteria for idiopathic inflammatory demyelinating disorders of the central nervous system. Conclusions Differential diagnosis leading to MS or alternatives is complex and a strong evidence base is lacking. Consensus-determined guidelines provide a practical path for diagnosis and will be useful for the non-MS specialist neurologist. Recommendations are made for future research to validate and support these guidelines. Guidance on the differential diagnosis process when MS is under consideration will enhance diagnostic accuracy and precision.
Subfields: Neurology, Pathology and Forensic Medicine
View Paper: https://www.semanticscholar.org/paper/7f103d92cbe16a4a4d905ce655e0b35526936d13
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Citations in the corpus
- Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria (2011, methodology): “Scans at 7.0T showed lesions in the white and gray matter with enhanced in vivo detection of pathological hallmarks of MS lesions.80–83 Finally, MRI techniques such as magnetic transfer imaging allow the detection of damage outside focal lesions (for instance, in normal-appearing brain tissues) not ”
- MOG encephalomyelitis: international recommendations on diagnosis and antibody testing (2018, background): “Most of the information given in a previous consensus paper on differential diagnosis in MS [38] is also pertinent to MOG-EM.”