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Migraines & Other "Common" Ill's Being Mistaken for MS

September 22, 2016

Patients with a number of common conditions — some neurological and some autoimmune, but others not — are being mistakenly diagnosed with multiple sclerosis (MS) because of difficulties in correctly determining this disease and, possibly, pressure to begin treatment early in the disease’s course, according to a recent study published in the journal Neurology.

“Although many rare disorders are known to mimic MS, it appears that presently, a number of common disorders are frequently mistaken for MS,” Andrew Solomon, MD, from the University of Vermont and the study’s lead author, said in a news release.

Several factors likely contribute to this problem, such as the lack of specific disease markers or blood tests to diagnose MS, the combination of different genetic and environmental factors responsible for the development of the disease, and the wide range of symptoms associated with the nerve damage observed in MS patients.

In the study, “The Contemporary Spectrum Of Multiple Sclerosis Misdiagnosis,”  Solomon and colleagues — all MS specialists working at four MS academic centers in the U.S. (University of Vermont, Mayo Clinic, Washington University, and Oregon Health & Science University) — pooled data on people they found to be wrongly diagnosed with MS.

Specifically, the neurologists identified 110 people either “definitely” (51 patients) or “probably” (59) misdiagnosed. Of these, 73 patients had one of five conditions: migraine (alone or in combination with other problems), fibromyalgia, an abnormal MRI (magnetic resonance imaging, a test widely used in MS diagnosis) with nonspecific or non-localizing neurologic symptoms, a psychological condition, or neuromyelitis optical spectrum disorder (a disease that induces damage to the optic nerves and spinal cord).

As a consequence of the misdiagnosis, 72% of the patients were incorrectly medicated — treated for MS — sometimes taking MS medications for “many” years. This is relevant, because some MS treatments can have serious side effects. Moreover, 33% of the patients remained misdiagnosed for at least 10 years before being informed they did not have MS by the researchers.

There is pressure to make the diagnosis of MS early, and to start patients on MS therapies quickly,” said Solomon. “But in some patients who do not meet our diagnostic criteria, waiting longer and following them closely may help determine the correct diagnosis.”

The authors hope their study will help to increase awareness about the challenges in correctly diagnosing MS, leading to better physician education, and encourage further study into possible misdiagnoses.