Clearing the Thicket of Misdiagnosed Multiple Sclerosis

Efforts to diagnose multiple sclerosis (MS) earlier, using simplified criteria, sometimes lead to misdiagnosis. To learn about how physicians handle this dilemma, investigators e-mailed surveys to 242 neurologists with an active MS practice.

Most of the 122 respondents had long-standing experience in treating MS, had completed an MS fellowship, and worked at a U.S. academic MS center. Of the 95% of respondents who within the past year had evaluated a patient they “strongly felt did NOT in fact have MS,” a plurality had seen three to five such patients. Alternative diagnoses included nonspecific white-matter abnormalities, small-vessel ischemic disease, migraine, psychiatric disease, neuromyelitis optica, and fibromyalgia.

Most respondents fou…