Multiple Sclerosis: The Problem of Incorrect Diagnosis
Abstract
Various neurologic disorders may be diagnosed incorrectly as multiple sclerosis (MS) since there is no test that is entirely specific for the disease. We report ten patients who met clinical criteria for probable or definite MS and who were given incorrect diagnoses. All of the patients were subsequently shown to have alternative diagnoses, three of which were directly treatable. From these illustrative cases, five characteristics were identified that alerted us to the possibility of an alternative diagnosis. We have called these characteristics "red flags," and suggest that they may be useful as features casting doubt on the diagnosis of MS if used judiciously in conjunction with clinical diagnostic criteria.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A 1986 case series describing ten patients who were misdiagnosed with MS found one patient whose final diagnosis was 'hysteria'.
“A 1986 case series describing ten patients who were misdiagnosed with MS found one patient whose final diagnosis was “hysteria” [31].”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [31]
Cited by
Sorted by citations
Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria
Thompson, A. J., Banwell, B. L., Barkhof, F., Carroll, W. M., Coetzee, T., Comi, G., Correale, J., Fazekas, F., Filippi, M., Freedman, M. S., et al. (2018) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30470-2 · Cited by 8,167 · see citing works
The contemporary spectrum of multiple sclerosis misdiagnosis
Solomon, A. J., Bourdette, D. N., Cross, A. H., Applebee, A., Skidd, P. M., Howard, D. B., Spain, R. I., Cameron, M. H., Kim, E., Mass, M. K., et al. (2016) · Neurology · doi:10.1212/wnl.0000000000003152 · Cited by 334 · see citing works
Walzl, D., Solomon, A. J., & Stone, J. (2022) · Journal of Neurology · doi:10.1007/s00415-021-10436-6 · Cited by 62 · see citing works
Aldraihem, M., Alyami, W., AlQahtani, E., Saeed, L., AlDosary, R., Altowaijri, G., & Almutlaq, A. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106779
- Authors
- Rudick, R. A.
- Affiliations
- University of Rochester (US)
- Corresponding author
- Rudick, Richard A.
- ORCID
- Rudick, Richard A.
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 1986-06-01
- Volume
- 43
- Issue
- 6
- Pages
- 578
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2131726821
- Cited by
- 83
- References
- 0
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 4 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 5.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r23ns020838-03, 5k07ns000791-03)
- National Institute of Neurological Disorders and Stroke (KO7 NS 00791, R23 NS 20838)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Keywords
- multiple sclerosis, misdiagnosis, differential diagnosis, red flags, diagnostic criteria, neurological disorders
- MeSH terms
- Adult, Brain, Diagnostic Errors, Eye, Female, Humans, Immunoglobulin G, Male, Middle Aged, Multiple Sclerosis, Magnetic Resonance Spectroscopy, Remission, Spontaneous, Time Factors, Tomography, X-Ray Computed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review