Diseases That Mimic MS
MS: H, E, MRI, L.P
By Chris Ratliff
*Hardly unusual to hear stories of people who
have been misdiagnosed several times before
finally being diagnosed with MS.
*Others remain in limbo for years, wondering if
they will ever get a definite MS diagnosis.
*No single Dx test
*Many Ds manifest symptoms similar to MS.
*Process of elemintaion sometimes is the only way
to Dx MS. The earlier the better outcome.
Autoimmune:
1-SLE: great imitator
*skin:rash,photosensitivity,raynauds,alopecia
*joint:arthritis,arthaglia
*blood:anemia
*kidney:R.F
*cns:seizures
*Gyne: first trimester abortion quite common in sle not in MS
*ANA: although MS can produce + ANA
*Urnianlysis or kidney biopsy
*MRI,CT,CXR,ECHO
2-Sjogren:
*Dry eye, dry mouth, difficulty swallowing, speaking
*Joint pain
*Decreased sensation
Can have pleatue,worsen,remission.
NCV : peripheral nerve damage, MS=central, if sjogren affect
cns can cause cognitive impairment and sp.cord involovement.
3-Sarcoidosis:
Age 20-40, appears briefly heals naturally.
20-30% permanent lung damage.
10-15% chronic Ds
Dry mouth, excessive thirst, rash, vision, arthritis,SOB,Enlarged
L.N, cough ,fever
*CXR
4-Mysathenia Gravis:
Fluctuate throuthout the day,worsen at night.
Drop eyelids, facial weakness, impaied eye coordination,
weakness of limbs,neck,shoulder,hips,trunk.
Muscle fatige,heat,overexertion,increased stress aggravate the
symptoms
Occur at any age(young woman,old man)
*NO LOSS OR CHANGE IN SENSATION, GENERAL FATIGURE. But
local fatigue.
*Anti-ACR Ab.
Infectious:
1-lyme:
Severe fatigue, neck stiffness,numbness,faical palsy.
Primary symptom rash.
Dx=Symptoms+Evidence of tick bite
(Hiking,camping,fishing,hunting,endemic)
Blood results can give false negative if performed in first month
after infection
2-HTLV-1:
Spacitcity,partial paralysis of L.L,Bladder,bowel
inconteince,impotence.
Ruled out with titer.
It affect sp.cord & appear similar to progressive MS.
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3-Neurosypihils:
Visual-cognitive,seneory,motor.
Ruled out by Ab.
Vascular:
1-Stroke:
Major strokes unlikely to be confused with MS, smaller strokes
produce changes or loss in function look similar to MS.
2-CNS Angitis:
Headache and confusion, slowly progressive
3-Dural AVM
4-Binswanger Ds.
OTHERS:
1-migraine
2-mitochondrial ds
3-muscular dystrophy
4-ALS
5-Hypothyroidism
6-HTN
7-Arnold chiairi malformation
8-behcet
9-fibromyaglia
10-vit B12 def