Diagnosis and Differential Diagnosis of MS

Abstract:

Multiple sclerosis (MS) is heterogeneous disease with no unique, highly specific biomarker. There are two distinct clinical phenotypes of the disease, relapsing-remitting and progressive, characterized by inflammatory and degenerative pathogenetic mechanism, but in different proportion. For any of these phenotypes there is no highly specific or sensitive biomarker. Therefore, diagnosis of MS is made on the basis of diagnostic criteria. The currently valid criteria are the McDonald’s criteria from 2017. The diagnosis of MS can only be established with clinical and/or radiological demonstration of lesions in the CNS that are disseminated in space (DIS) and time (DIT). Magnetic resonance imaging (MRI) is the most sensitive diagnostic/paraclinical method for detection of typical MS brain and spinal cord lesions. To avoid misdiagnosis of MS, it is important to be aware of clinical and paraclinical „red flags“ suggesting that there is a better explanation for patient’s symptoms and findings of diagnostic procedures than MRI.

Key words:
differential diagnosis; McDonald diagnostic criteria; multiple sclerosis