Differential Diagnosis of Multiple Sclerosis
Disorder - Distinguishing features
- Acute disseminated encephalomyelitis - Follows
infections or vaccination in children, fever, headaches,
and meningism common
- Lyme disease - Antibodies to Borrelia species
antigens in serum and CSF
- HIVassociated myelopathy - HIV antibodies
present
- HTLVI myelopathy - HTLVI antibodies present in
serum/CSF
- Neurosyphllis - Syphilis antibodies present in
serum/CSF
- Progressive multifocal leukoencephalopathy -
Immunosuppressed patients; biopsy of lesions demonstrates
virus by electron microscopy
- Systemic lupus erythematosus - NonCNS
manifestations of lupus; antinuclear antibodies,
antidsDNA
- Polyarteritis nodosa - Systemic signs; angiography
shows microaneurysms; biopsy of involved areas shows
vasculitis
- Sjogren's syndrome - Dry eyes and mouth; antiRo
and antiLa antibodies; lower lip biopsy helpful
- Behcet's disease - Oral/genital ulcers; antibodies
to oral mucosa
- Sarcoidosis - NonCNS signs; increased protein in
CSF; biopsy shows granuloma
- Paraneoplastic syndromes - Older agegroup;
antiYo antibodies; identify neoplasm
- Subacute combined degeneration of cord -
Peripheral neuropathy; vitamin B12 levels
- Subacute myeloopticoneuropathy - Mainly in
Japanese; adverse reaction to chlorhydroxyquinoline
- Adrenomyeloneuropathy - Adrenal dysfunction;
neuropathy; plasma very long chain fatty acids increased
- Spinocerebellar syndromes - Familial; pes cavus;
scoliosis; absent reflexes; normal CSF IgG and no bands
- Hereditary spastic paraparesis/ primary lateral
sclerosis - Normal CSF, MRI, and visual evoked
potential studies
- Miscellaneous - Strokes, tumors, arteriovenous
malformations, arachnoid cysts, ArnoldChiari
malformations, and cervical spondylosis all may lead to
diagnostic dilemmas on occasion. These conditions may
coexist differentiation based on history, clinical
followup, and MRI features.
Return to The Intern in the Middle of
the Night Home Page
Return
to LSUHSC-S Family Medicine Home Page
Return
to the LSUHSC-S Home Page.