A differential diagnosis of central nervous system demyelination: beyond multiple sclerosis
- 20 September 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in Zeitschrift für Neurologie
- Vol. 259 (5), 801-816
- https://doi.org/10.1007/s00415-011-6240-5
Abstract
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.This publication has 139 references indexed in Scilit:
- Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteriaAnnals of Neurology, 2011
- Clinical study of childhood acute disseminated encephalomyelitis, multiple sclerosis, and acute transverse myelitis in Fukuoka Prefecture, JapanBrain & Development, 2010
- Neuro-Behçet's disease: epidemiology, clinical characteristics, and managementThe Lancet Neurology, 2009
- Differential diagnosis of suspected multiple sclerosis: a consensus approachMultiple Sclerosis Journal, 2008
- Variable responses to rituximab treatment in neuromyelitis optica (Devic’s disease)Neurological Sciences, 2007
- The long (-itudinally extensive) and the short of itNeurology, 2007
- Immunosuppressive therapy is more effective than interferon in neuromyelitis opticaMultiple Sclerosis Journal, 2007
- Controlled clinical trial of IV cyclophosphamide versus IV methylprednisolone in severe neurological manifestations in systemic lupus erythematosusAnnals Of The Rheumatic Diseases, 2005
- Acute Disseminated Encephalomyelitis: Response to Intravenous Immunoglobulin?Journal of Child Neurology, 1995
- Acute transverse myelopathy complicating systemic lupus erythematosus.Annals Of The Rheumatic Diseases, 1989