Cited by 100Multiple Sclerosis Research StudiesClinical Reasoning and Diagnostic SkillsRadiology practices and education

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Misdiagnosis of Multiple Sclerosis: Frequency, Causes, Effects, and Prevention

Solomon, Andrew J., Weinshenker, Brian G.·2013·Current Neurology and Neuroscience Reports

Abstract

A diagnosis of multiple sclerosis is heavily influenced by clinical judgment. Misdiagnosis of multiple sclerosis is common and has important consequences for patients and the cost of healthcare. Although rigorous data about the frequency and causes of misdiagnosis are lacking, misinterpretation and misapplication of clinical and radiographic diagnostic criteria and terminology are likely important factors. Appropriate and stringent application of diagnostic criteria and continued vigilance for "red flags" suggesting alternative diagnoses are strategies critical for prevention of misdiagnosis.

Overview

Integrity signals

Registry

Crossref · 10.1007/s11910-013-0403-y

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

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?

  • Advances in MRI, serological and genetic tests have greatly helped in distinguishing MS from conditions that mimic it, but misdiagnosis can occur.

    “Advances in MRI, serological and genetic tests have greatly helped in distinguishing MS from these conditions, but misdiagnosis can occur.”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [63]

  • These disorders usually present quite differently to MS and reasons for misdiagnosis included misinterpretation of clinical findings (symptoms not typical of demyelination, absence of objective neurological signs) and inappropriate application of MRI criteria.

    “These disorders usually present quite differently to MS and reasons for misdiagnosis included misinterpretation of clinical findings (symptoms not typical of demyelination, absence of objective neurological signs) and inappropriate application of MRI criteria.63”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [63]

  • Rates of misdiagnosis of MS may be as high as 10%.

    “Rates of misdiagnosis of MS may be as high as 10%.63”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [63]

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 72

  1. Millar JH, Allison RS. Familial incidence of disseminated sclerosis in Northern Ireland. Ulster Med J. 1954;23 Suppl 2:29–92.
  2. Poser CM, Brinar VV. Diagnostic criteria for multiple sclerosis: an historical review. Clin Neurol Neurosurg. 2004;106:147–58. doi: 10.1016/j.clineuro.2004.02.004 . · DOI
  3. Broman T, Bergmann L, Fog T, Gilland O, Hyllested K, Lindberg-Broman AM, et al. Aspects on classification methods in multiple sclerosis. Acta Neurol Scand Suppl. 1965;13(Pt 2):543–8.
  4. Schumacker GA, Beebe G, Kibler RF, Kurland LT, Kurtzke JF, McDowell F, et al. Problems of Experimental Trials of Therapy in Multiple Sclerosis: report by the Panel on The Evaluation of Experimental Trials of Therapy in Multiple Sclerosis. Ann NY Acad Sci. 1965;122:552–68. · DOI · Paper page
  5. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983;13:227–31. doi: 10.1002/ana.410130302 . · DOI · Paper page
  6. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001;50:121–7. · DOI · Paper page
  7. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol. 2005;58:840–6. doi: 10.1002/ana.20703 . · DOI · Paper page
  8. Herndon RM. Multiple sclerosis mimics. Adv Neurol. 2006;98:161–6.
  9. Bowen J. Diagnosing multiple sclerosis and its imitators. Phys Med Rehab Clin NA. 2005;16:359–81. doi: 10.1016/j.pmr.2005.01.011 . · DOI
  10. Miller DH, Weinshenker BG, Filippi M, Banwell BL, Cohen JA, Freedman MS, et al. Differential diagnosis of suspected multiple sclerosis: a consensus approach. Mult Scler. 2008;14:1157–74. doi: 10.1177/1352458508096878 . · DOI · Paper page
  11. Natowicz MR, Bejjani B. Genetic disorders that masquerade as multiple sclerosis. Am J Med Genet. 1994;49:149–69. doi: 10.1002/ajmg.1320490202 . · DOI
  12. Davis RL, Robertson DM. Textbook of neuropathology. 2nd ed. Baltimore: Williams & Wilkins; 1990.
  13. Engell T. A clinico-pathoanatomical study of multiple sclerosis diagnosis. Acta Neurol Scand. 1988;78:39–44. · DOI
  14. Herndon RMBB. Misdiagnosis of multiple sclerosis. Semin Neurol. 1985;5:94–8. · DOI
  15. Rudick RA, Schiffer RB, Schwetz KM, Herndon RM. Multiple sclerosis. The problem of incorrect diagnosis. Arch Neurol. 1986;43:578–83. · DOI · Paper page
  16. Noseworthy JH, Rice GP. Trichlorethylene poisoning mimicking multiple sclerosis. Can J Neurol Sci. 1988;15:87–8. · DOI
  17. Bender GP, Schapiro RT. Primary CNS lymphoma presenting as multiple sclerosis. A case study. Minn Med. 1989;72:157–60.
  18. Bussone G, La Mantia L, Grazzi L, Lamperti E, Salmaggi A, Strada L. Neurobrucellosis mimicking multiple sclerosis: a case report. Eur Neurol. 1989;29:238–40. · DOI
  19. Scott TF, Hess D, Brillman J. Antiphospholipid antibody syndrome mimicking multiple sclerosis clinically and by magnetic resonance imaging. Arch Int Med. 1994;154:917–20. · DOI
  20. Vrethem M, Thuomas KA, Hillman J. Cavernous angioma of the brain stem mimicking multiple sclerosis. N Engl J Med. 1997;336:875–6. doi: 10.1056/nejm199703203361213 . · DOI
  21. Dougan CF, Coulthard A, Cartlidge NE, Burn DJ. Familial cavernous angiomas masquerading as multiple sclerosis. Postgrad Med J. 1998;74:489–91. · DOI
  22. Russo MB, Brooks FR, Fontenot J, Dopler BM, Neely ET, Halliday AW. Conversion disorder presenting as multiple sclerosis. Milit Med. 1998;163:709–10. · DOI
  23. Cader MZ, Winer JB. Lesson of the week: cavernous haemangioma mimicking multiple sclerosis. BMJ (Clin Res ed). 1999;318:1604–5. · DOI
  24. Ormsby A, Prayson RA, Heard R. Angiotrophic large cell lymphoma mimicking multiple sclerosis associated transverse myelitis. J Clin Neurosci. 1999;6:408–10. doi: 10.1054/jocn.1998.0091 . · DOI
  25. Evans RW, Rolak LA. Migraine vs multiple sclerosis. Headache. 2001;41:97–8. · DOI
  26. O'Riordan S, Nor AM, Hutchinson M. CADASIL imitating multiple sclerosis: the importance of MRI markers. Mult Scler. 2002;8:430–2. · DOI · Paper page
  27. Tiryaki E, Azzarelli B, Biller J. Superficial siderosis of the central nervous system in a patient with chronic subarachnoid hemorrhage misdiagnosed as multiple sclerosis. J Stroke Cerebrovasc Dis. 2002;11:288–9. doi: 10.1053/jscd.2002.129618 . · DOI
  28. Fernandez-Fernandez FJ, Rivera-Gallego A, de la Fuente-Aguado J, Perez-Fernandez S, Munoz-Fernandez D. Antiphospholipid syndrome mimicking multiple sclerosis in two patients. Eur J Int Med. 2006;17:500–2. doi: 10.1016/j.ejim.2006.02.018 . · DOI
  29. Rafalowska J, Dziewulska D, Podlecka A, Zakrzewska-Pniewska B. Extensive mixed vascular malformation clinically imitating multiple sclerosis—case report. Clin Neuropathol. 2006;25:237–42.
  30. Saip S, Uluduz D, Erkol G. Fabry disease mimicking multiple sclerosis. Clin Neurol Neurosurg. 2007;109:361–3. doi: 10.1016/j.clineuro.2006.12.006 . · DOI
  31. Beeravolu LR, Frohman EM, Frohman TC, Remington GM, Lee S, Levin MC. Pearls & Oy-sters: "Not multiple sclerosis" and the changing face of HTLV-1: a case report of downbeat nystagmus. Neurology. 2009;72:e119–20. doi: 10.1212/WNL.0b013e3181aa5316 . · DOI
  32. Boentert M, Kraus J, Kloska S, Dittrich R, Nabavi DG, Niederstadt T, et al. Obliterating intracranial vasculopathy mimicking multiple sclerosis. Acta Neurol Scand. 2009;120:68–71. doi: 10.1111/j.1600-0404.2008.01121.x . · DOI
  33. Chebel S, Barboura I, Boughammoura-Bouatay A, Ammar M, Ferchichi S, Miled A, et al. Adult-type metachromatic leukodystrophy mimicking multiple sclerosis. Can J Neurol Sci. 2009;36:521–3. · DOI
  34. Matsuo Y, Kamezaki K, Takeishi S, Takenaka K, Eto T, Nonami A, et al. Encephalomyelitis mimicking multiple sclerosis associated with chronic graft-vs-host disease after allogeneic bone marrow transplantation. Int Med (Tokyo, Japan). 2009;48:1453–6. · DOI
  35. Papadimas GK, Rentzos M, Zouvelou V, Kilidireas K, Konstantinopoulou A, Kokotis P, et al. Superficial siderosis of central nervous system mimicking multiple sclerosis. Neurologist. 2009;15:153–5. doi: 10.1097/NRL.0b013e31818a5d3a . · DOI
  36. Brinar VV, Habek M. Rare infections mimicking MS. Clin Neurol Neurosurg. 2010;112:625–8. doi: 10.1016/j.clineuro.2010.04.011 . · DOI
  37. Utsuki S, Oka H, Miyazaki T, Yamazaki T, Yasui Y, Fujii K, et al. Primary central nervous system large B-cell lymphoma with prolific, mixed T-cell and macrophage infiltrates, mimicking multiple sclerosis. Brain Tumor Pathol. 2010;27:59–63. doi: 10.1007/s10014-010-0264-x . · DOI
  38. Stricker RB, Johnson L. 'Rare' infections mimicking multiple sclerosis: consider Lyme disease. Clin Neurol Neurosurg. 2011;113:259–60. doi: 10.1016/j.clineuro.2010.11.017 . · DOI
  39. Dorfman LJ, Fischbein NJ, Woodard JI, Choudhri O, Bell-Stephens TE, Steinberg GK. Moyamoya disease can masquerade as multiple sclerosis. Neurologist. 2012;18:398–403. doi: 10.1097/NRL.0b013e31826a99a1 . · DOI
  40. Ohe Y, Hayashi T, Mishima K, Nishikawa R, Sasaki A, Matsuda H, et al. Central nervous system lymphoma initially diagnosed as tumefactive multiple sclerosis after brain biopsy. Int Med (Tokyo, Japan). 2013;52:483–8. · DOI
  41. Murray TJ, Murray SJ. Characteristics of patients found not to have multiple sclerosis. Can Med Assoc J. 1984;131:336–7.
  42. Carmosino MJ, Brousseau KM, Arciniegas DB, Corboy JR. Initial evaluations for multiple sclerosis in a university multiple sclerosis center: outcomes and role of magnetic resonance imaging in referral. Arch Neurol. 2005;62:585–90. doi: 10.1001/archneur.62.4.585 . · DOI · Paper page
  43. Brousseau KM, Arciniegas DB, Carmosino MJ, Corboy JR. The differential diagnosis of Axis I psychopathology presenting to a university-based multiple sclerosis clinic. Mult Scler. 2007;13:749–53. doi: 10.1177/1352458506075032 . · DOI · Paper page
  44. Pelidou SH, Giannopoulos S, Tzavidi S, Tsifetaki N, Kitsos G, Stefanou D, et al. Neurological manifestations of connective tissue diseases mimicking multiple sclerosis. Rheumatol Int. 2007;28:15–20. doi: 10.1007/s00296-007-0384-8 . · DOI
  45. Poser CM. Misdiagnosis of multiple sclerosis and beta-interferon. Lancet. 1997;349:1916. doi: 10.1016/s0140-6736(05)63920-7 . · DOI · Paper page
  46. Nielsen JM, Korteweg T, Barkhof F, Uitdehaag BM, Polman CH. Overdiagnosis of multiple sclerosis and magnetic resonance imaging criteria. Ann Neurol. 2005;58:781–3. doi: 10.1002/ana.20632 . · DOI · Paper page
  47. • Solomon AJ, Klein EP, Bourdette D. "Undiagnosing" multiple sclerosis: the challenge of misdiagnosis in MS. Neurology. 2012;78:1986–91. doi: 10.1212/WNL.0b013e318259e1b2 . Recent survey concerning MS misdiagnosis providing data on frequency and hypothesized causes. · DOI · Paper page
  48. Poser CM, Brinar VV. Problems with diagnostic criteria for multiple sclerosis. Lancet. 2001;358:1746–7. doi: 10.1016/s0140-6736(01)06842-8 . · DOI
  49. Rudick RA. Diagnostic criteria in multiple sclerosis: headed in the right direction but still a ways to go. Ann Neurol. 2011;69:234–6. doi: 10.1002/ana.22388 . · DOI
  50. Schiffer RB, Giang DW, Mushlin A, Ketonen L, Joy S, Kido D, et al. Perils and pitfalls of magnetic resonance imaging in the diagnosis of multiple sclerosis. The Rochester-Toronto MRI Study Group. J Neuroimag. 1993;3:81–8. · DOI
  51. Whiting P, Harbord R, Main C, Deeks JJ, Filippini G, Egger M, et al. Accuracy of magnetic resonance imaging for the diagnosis of multiple sclerosis: systematic review. BMJ (Clin Res Ed). 2006;332:875–84. doi: 10.1136/bmj.38771.583796.7C . · DOI
  52. Kim SS, Richman DP, Johnson WO, Hald JK, Agius MA. Limited utility of current MRI criteria for distinguishing multiple sclerosis from common mimickers: primary and secondary CNS vasculitis, lupus and Sjogren's syndrome. Multiple Sclerosis. 2013. doi: 10.1177/1352458513491329 . · DOI
  53. • Liu S, Kullnat J, Bourdette D, Simon J, Kraemer DF, Murchison C, et al. Prevalence of brain magnetic resonance imaging meeting Barkhof and McDonald criteria for dissemination in space among headache patients. Multiple Sclerosis. 2013. doi: 10.1177/1352458512471874 . Recent study demonstrating the limitations of MS imaging crtieria. · DOI · Paper page
  54. Charil A, Yousry TA, Rovaris M, Barkhof F, De Stefano N, Fazekas F, et al. MRI and the diagnosis of multiple sclerosis: expanding the concept of "no better explanation". Lancet Neurol. 2006;5:841–52. doi: 10.1016/s1474-4422(06)70572-5 . · DOI
  55. Polman CH, Wolinsky JS, Reingold SC. Multiple sclerosis diagnostic criteria: three years later. Mult Scler. 2005;11:5–12. · DOI
  56. Okuda DT, Mowry EM, Beheshtian A, Waubant E, Baranzini SE, Goodin DS, et al. Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome. Neurology. 2009;72:800–5. doi: 10.1212/01.wnl.0000335764.14513.1a . · DOI · Paper page
  57. Bourdette D, Yadav V. The radiologically isolated syndrome revisited: when is it presymptomatic multiple sclerosis? Neurology. 2011;76:680–1. doi: 10.1212/WNL.0b013e31820e7769 . · DOI
  58. Bourdette D, Yadav V. Treat patients with radiologically isolated syndrome when the MRI brain scan shows dissemination in time no. Multiple. 2012;18:1529–30. doi: 10.1177/1352458512462075 . · DOI
  59. Spain R, Bourdette D. The radiologically isolated syndrome: look (again) before you treat. Curr Neurol Neurosci Rep. 2011;11:498–506. doi: 10.1007/s11910-011-0213-z . · DOI
  60. Groopman JE. How doctors think. Boston: Houghton Mifflin; 2007.
  61. Boissy AR, Ford PJ. A touch of MS: therapeutic mislabeling. Neurology. 2012;78:1981–5. doi: 10.1212/WNL.0b013e318259e0ec . · DOI
  62. Tullman MJ. Overview of the epidemiology, diagnosis, and disease progression associated with multiple sclerosis. Am J Manag Care. 2013;19(2 Suppl):S15–20.
  63. Rudick RA, Miller AE. Multiple sclerosis or multiple possibilities: the continuing problem of misdiagnosis. Neurology. 2012;78:1904–6. doi: 10.1212/WNL.0b013e318259e2e2 . · DOI
  64. Solomon AJ, Klein E. Disclosing a misdiagnosis of multiple sclerosis: do no harm? Continuum. 2013;19(4 Multiple Sclerosis):1087–91. doi: 10.1212/01.CON.0000433281.18146.5b . · DOI · Paper page
  65. Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington: National Academy Press; 2000.
  66. Dobson R, Ramagopalan S, Davis A, Giovannoni G. Cerebrospinal fluid oligoclonal bands in multiple sclerosis and clinically isolated syndromes: a meta-analysis of prevalence, prognosis and effect of latitude. J Neurol Neurosurg Psychiatry. 2013. doi: 10.1136/jnnp-2012-304695 . · DOI · Paper page
  67. Alvarez-Cermeno JC, Villar LM. Multiple sclerosis: oligoclonal bands-a useful tool to avoid MS misdiagnosis. Nature Rev Neurol. 2013. doi: 10.1038/nrneurol.2013.74 . · DOI
  68. Hutchinson M. CSF oligoclonal bands are important in the diagnosis of multiple sclerosis, unreasonably downplayed by the McDonald Criteria 2010: commentary. Mult Scler. 2013;19:719–20. doi: 10.1177/1352458513485496 . · DOI · Paper page
  69. Sandberg-Wollheim M, Olsson T. Cerebrospinal fluid oligoclonal bands are important in the diagnosis of multiple sclerosis, unreasonably downplayed by the McDonald criteria 2010: yes. Mult Scler. 2013;19:714–6. doi: 10.1177/1352458513480011 . · DOI
  70. Bates D. Treatment effects of immunomodulatory therapies at different stages of multiple sclerosis in short-term trials. Neurology. 2011;76(1 Suppl 1):S14–25. doi: 10.1212/WNL.0b013e3182050388 . · DOI
  71. Coyle PK. Early treatment of multiple sclerosis to prevent neurologic damage. Neurology. 2008;71(24 Suppl 3):S3–7. doi: 10.1212/WNL.0b013e31818f3d6f . · DOI
  72. Goodin DS, Reder AT, Ebers GC, Cutter G, Kremenchutzky M, Oger J, et al. Survival in MS: a randomized cohort study 21 years after the start of the pivotal IFNbeta-1b trial. Neurology. 2012;78:1315–22. doi: 10.1212/WNL.0b013e3182535cf6 . · DOI

Cited by

Sorted by citations

Metadata

Authors
Solomon, A. J., & Weinshenker, B. G.
Affiliations
  • University of Vermont (US)
  • Mayo Clinic (US)
Corresponding author
Solomon, Andrew J.
Venue
Current Neurology and Neuroscience Reports
Published
2013-10-20
Volume
13
Issue
12
Pages
403-403
ISSN
  • 1528-4042 (ISSN-L)
  • 1534-6293
OpenAlex
W1971211819
Cited by
100
References
2
Citations by year
2026: 5 · 2025: 5 · 2024: 10 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 11 · 2019: 12 · 2018: 11 · 2017: 12 · 2016: 12 · 2015: 6
FWCI
0.88
Type
journal article
Language
en
Open access
closed
Locations
  • Current Neurology and Neuroscience Reports (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
Keywords
multiple sclerosis, misdiagnosis, diagnostic criteria, red flags, clinical judgment, diagnostic terminology, health care costs
MeSH terms
Diagnostic Errors, Humans, Multiple Sclerosis

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