What can mimic MS on MRI?

Some of the most common mimics include migraine and chronic cerebrovascular disease, according to Dr Schiess. Vasculitic autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjögren's syndrome can also result in white matter abnormalities on MRI.

What other conditions can be mistaken for MS?

Can MRI misdiagnosed MS?

Misinterpretation of abnormal MRI findings is a frequent contributor to misdiagnosis of MS. One study found that only 11% of patients who were referred to a MS subspecialty center based primarily on an abnormal MRI were subsequently diagnosed with MS.

How do you rule out MS?

Can pinched nerves mimic MS?

It is also common for people and doctors to misattribute the initial symptoms of MS to something more benign, such as a pinched nerve or muscle strain. Sometimes a person may have the symptoms of MS for many years before he or she seeks medical attention and receives a correct diagnosis.

what are the MS mimics that you don"t want to miss

Are inflammatory markers raised in MS?

Abstract. Inflammation in a myelinated portion of the nervous system is the mainstay of multiple sclerosis (MS). Elevation of inflammatory markers such as procalcitonin, ESR and hs-CRP is suspected to occur in MS patients.

Can brain lesions be something other than MS?

Lesions can be due to disease, trauma or a birth defect. Sometimes lesions appear in a specific area of the brain. At other times, the lesions are present in a large part of the brain tissue. At first, brain lesions may not produce any symptoms.

Do brain lesions always mean MS?

Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI.

Can you have demyelination without MS?

Other non-MS demyelinating disorders

Neuromyelitis optica (NMO) — A separate disease from MS that shares several clinical features. NMO most often causes visual changes in both eyes and symptoms caused by long lesions in the spinal cord.

Can MS be misdiagnosed?

The misdiagnosis of multiple sclerosis (MS) is a problem with significant consequences for patients as well as the healthcare system. There are nearly 1 million people in the United States living with the disease. And researchers now say nearly 20 percent of them are misdiagnosed.

Can Sjogren's mimic MS?

Abstract. Background: Primary Sjögren's syndrome (SS) with central nervous system involvement and antiphospholipid syndrome have been reported to mimic multiple sclerosis (MS). SS has also been found in patients diagnosed with definite MS.

Can iron deficiency mimic MS?

"Iron depletion or increase in several structures of the brain is an independent predictor of disability related to MS." The results point to a potential role for quantitative susceptibility mapping in clinical trials of promising new drugs, Dr. Zivadinov said.

Can Covid cause demyelination?

Accumulating evidence confirms the SARS-CoV-2 viral infection as a risk factor of demyelination both in the peripheral and central nervous systems. In agreement with this idea, Zanin et al. reported a case of COVID-19 admitted for interstitial pneumonia and seizures.

What does demyelination feel like?

MS and other demyelinating diseases most commonly result in vision loss, muscle weakness, muscle stiffness and spasms, loss of coordination, change in sensation, pain, and changes in bladder and bowel function.

What types of symptoms would you expect from a demyelinating disease?

What does early MS look like on MRI?

MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.

How many lesions are needed for MS diagnosis?

According to updates made in 2017, MS can be diagnosed based on these findings: two attacks or symptom flare-ups (lasting at least 24 hours with 30 days between attacks), plus two lesions. two attacks, one lesion, and evidence of dissemination in space (or a different attack in a different part of the nervous system)

What does it mean when you have white matter on a brain MRI?

White matter disease is commonly detected on brain MRI of aging individuals as white matter hyperintensities (WMH), or 'leukoaraiosis.” Over the years it has become increasingly clear that the presence and extent of WMH is a radiographic marker of small cerebral vessel disease and an important predictor of the life- ...

Can white matter lesions in the brain be nothing?

Studies have found that white matter lesions appear in some degree on brain scans of most older adults but less often in younger people. White matter lesions are among the most common incidental findings—which means the lesions have no clinical significance—on brain scans of people of any age.

What is the McDonald criteria for MS?

To fulfill a diagnosis of MS based on the 2017 McDonald criteria, an individual must have: evidence of CNS damage that is disseminating in space, or appearing in multiple regions of the nervous system. evidence of damage that is disseminating in time, or occurring at different points in time.

Is white matter the same as lesions?

White Matter Lesions on Magnetic Resonance Imaging. White matter lesions (WMLs), also called white matter hyperintensities, are a common finding on T2 and fluid-attenuated inversion recovery (FLAIR) sequences on brain magnetic resonance imaging (MRI).

Does a high CRP level indicate MS?

CRP is higher during MS relapses and associated with EDSS, predictive for later progression and decreasing during interferon beta 1a therapy (30–32). Therefore, peripheral inflammation is probably linked to general disease activity in MS, too.

What blood work indicates MS?

While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including lupus erythematosis, Sjogren's, vitamin and mineral deficiencies, some infections, and rare hereditary diseases.

Is ANA positive with MS?

While your ANA test can be positive if you have MS, it's used more to rule out lupus as a cause of your symptoms, not to help diagnose MS. MS and lupus are similar in other ways too: Both MS and lupus are lifelong (chronic).

Can you see demyelination on an MRI?

Magnetic resonance imaging (MRI) is the gold standard imaging technique for the identification of demyelinating lesions which can be used to support a clinical diagnosis of MS, and MS can now be diagnosed in some patients after a clinically isolated syndrome (CIS) using new MRI diagnostic criteria.