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Practicing neurologists are only too familiar with the overlap between multiple sclerosis (MS) and nonorganic symptomatology. The lack of a 100% specific and sensitive diagnostic test makes it difficult to rule out MS, especially at initial presentation.
These investigators retrospectively reviewed data from 143 patients who were referred to their tertiary center because of neurologic symptoms but had normal examination, brain MRI, CSF examination findings, and (when done) normal spinal cord MRI findings. These patients constituted 22% of their referral load.
Of 109 patients who underwent follow-up (mean duration, 4.4 years), all continued to have normal clinical examinations; repeated laboratory and imaging investigations, when performed, we…