A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis.

Published

Journal Article (Review)

Although multiple sclerosis (MS) is the most common demyelinating disorder of the central nervous system (CNS), it lacks any definitive diagnostic test. Instead, diagnosis of MS primarily depends upon clinical criteria, supported by abnormalities characteristic of MS on para-clinical investigations including magnetic resonance imaging of the brain and spine, in the absence of an alternative explanation for underlying neurologic symptoms. While many of the potential disorders that may mimic MS in routine clinical practice are either extremely rare, or associated with specific and characteristic distinguishing diagnostic features, some inflammatory demyelinating disorders of the CNS may be particularly challenging to distinguish from MS, especially during initial presentation. In particular, acute disseminated encephalomyelitis, neuromyelitis optica, and idiopathic transverse myelitis may closely resemble MS, impeding prompt and accurate diagnosis. In this review, we describe the clinical features, diagnosis, pathology, and treatment of these other CNS demyelinating disorders. In addition, we review relevant features of other CNS inflammatory disorders that may mimic MS, including Sjögren's syndrome, systemic lupus erythematosus, Behçet's disease, and primary CNS vasculitis.

Full Text

Duke Authors

Cited Authors

  • Eckstein, C; Saidha, S; Levy, M

Published Date

  • May 2012

Published In

Volume / Issue

  • 259 / 5

Start / End Page

  • 801 - 816

PubMed ID

  • 21932127

Pubmed Central ID

  • 21932127

Electronic International Standard Serial Number (EISSN)

  • 1432-1459

Digital Object Identifier (DOI)

  • 10.1007/s00415-011-6240-5

Language

  • eng

Conference Location

  • Germany