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CMSC: When It's Not MS

June 27, 2017

Turns out that some patients are misdiagnosed with multiple sclerosis (MS). According to researchers, more than 30% of patients sent to a tertiary clinic with a diagnosis of MS end up having something other than the disease. Marwa Kaisey, MD, of UCLA and Cedars-Sinai Medical Center in Los Angeles, and her colleagues evaluated patients who were sent to her specialty center to confirm a diagnosis of MS so the patient could begin disease-modifying therapy. Of 93 consecutive patients referred to an MS specialty clinic, re-evaluation found that 31 of these individuals did not have MS.

"There were no cases of purely psychiatric disease without underlying neurology," Kaisey said, adding that recent imaging studies and lumbar puncture-related tests were most likely the examinations that were able to differentiate the MS patients from those with misdiagnoses. Some of the results showed that falsely MS diagnoses were actually cerebral palsy, scleroderma complicated by neuropathy, hereditary muscular disease, fibromyalgia, optic neuritis, uveitis, headache, and anxiety. Kaisey notes that it was disturbing to see that 10% of these patients with the misdiagnosis had started disease-modifying agents for MS. She tells her patients that there is no one test to determine if one has MS, for it takes many evaluations. She stated that one survey of MS specialists found that 94% of these specialists had found at least one misdiagnosis in the past year.

David Brandes, MD, who is in a private practice with Hope Neurology/MS Center in Knoxville, Tennessee, stated that the findings by the Los Angeles group are similar to what he sees in clinical practice. He said that about 60% of his referral cases do not have MS. He also explained how Kaisey’s study proves that there can be a lot of misdiagnosis for MS. Many of these misdiagnoses come from neurologists, but also from MS specialists. It is important to go through multiple tests, as Kaisey suggested, in order to get the full picture and to determine the correct diagnosis.

Via MedPage Today