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Differential diagnosis of suspected multiple sclerosis: a consensus approach

Miller, D. H. and Weinshenker, B. G. and Filippi, M. and Banwell, B. L. and Cohen, J. A. and Freedman, M. S. and Galetta, S. L. and Hutchinson, M. and Johnson, R. T. and Kappos, L. and Kira, J. and Lublin, F. D. and McFarland, H. F. and Montalban, X. and Panitch, H. and Richert, J. R. and Reingold, S. C. and Polman, C. H.. (2008) Differential diagnosis of suspected multiple sclerosis: a consensus approach. Multiple Sclerosis Journal, 14 (9). pp. 1157-1174.

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Official URL: http://edoc.unibas.ch/dok/A6003869

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Abstract

BACKGROUND AND OBJECTIVES: Diagnosis of multiple sclerosis (MS) requires exclusion of diseases that could better explain the clinical and paraclinical findings. A systematic process for exclusion of alternative diagnoses has not been defined. An International Panel of MS experts developed consensus perspectives on MS differential diagnosis. METHODS: Using available literature and consensus, we developed guidelines for MS differential diagnosis, focusing on exclusion of potential MS mimics, diagnosis of common initial isolated clinical syndromes, and differentiating between MS and non-MS idiopathic inflammatory demyelinating diseases. RESULTS: We present recommendations for 1) clinical and paraclinical red flags suggesting alternative diagnoses to MS; 2) more precise definition of "clinically isolated syndromes" (CIS), often the first presentations of MS or its alternatives; 3) algorithms for diagnosis of three common CISs related to MS in the optic nerves, brainstem, and spinal cord; and 4) a classification scheme and diagnosis criteria for idiopathic inflammatory demyelinating disorders of the central nervous system. CONCLUSIONS: Differential diagnosis leading to MS or alternatives is complex and a strong evidence base is lacking. Consensus-determined guidelines provide a practical path for diagnosis and will be useful for the non-MS specialist neurologist. Recommendations are made for future research to validate and support these guidelines. Guidance on the differential diagnosis process when MS is under consideration will enhance diagnostic accuracy and precision.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Neurologie > Neuroimmunologie (Kappos)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Neurologie > Neuroimmunologie (Kappos)
UniBasel Contributors:Kappos, Ludwig
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:SAGE
ISSN:1352-4585
e-ISSN:1477-0970
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:02 Nov 2017 13:38
Deposited On:07 Dec 2012 13:03

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