Diagnosing MS regularly requires ruling out other feasible conditions with comparable symptoms.Stuart Kinlough/Getty Images
Getting a exactly diagnosis of multiple sclerosis (MS) can be a challenge. In fact, a study released in may 2019 in the journal Multiple Sclerosis and Related Disorders suggested that practically 1 in 5 world with other neurologic conditions are incorrectly diagnosed through MS.

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These errors in diagnosis likely an outcome from the reality that there is no solitary test that deserve to determine an ms diagnosis conclusively. Also, no everyone has all of the common symptoms of MS, such together numbness, tingling, pain, fatigue, and also heat sensitivity. And also to complicate matters, the symptom you do have actually may resemble those that some various other conditions.

To figure out those causing possible MS symptoms, doctors look at your clinical history, the outcomes of a neurological exam, and also an MRI — and sometimes do a spinal madness (also referred to as a lumbar puncture), says Jack Burks, MD, a neurologist and chief medical officer because that the Multiple Sclerosis association of America. "The diagnosis can additionally require remove the possible MS mimicker diseases," that says. That leads come an ms diagnosis by exclusion.

“Misdiagnosis in MS has actually been an issue that’s to be talked around for 40 years,” adds Jeffrey Cohen, MD, director of speculative therapeutics in ~ the Mellen MS center of the Cleveland Clinic in Ohio. “And even with refinement that diagnostic criteria and also the availability of technologies choose MRI, it’s tho a problem. There space a far-reaching number of people getting misdiagnosed v MS in component because yes sir no single test for it, choose a blood test.”

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Here are several of the problems that are periodically mistaken for multiple sclerosis:

1. Lyme Disease

Lyme disease is a bacterial infection transmitted v a mite bite. Beforehand symptoms incorporate fatigue, fever, headaches, and also muscle and joint aches. Later symptoms can encompass numbness and also tingling in the hands and feet, and cognitive problems, together as short-term memory loss and speech issues. If girlfriend live in one area that’s known come have Lyme disease or have recently traveled to one, your medical professional will desire to preeminence out the possibility, Dr. Burks says.


2. Migraine

A migraine is a kind of headache the can reason intense pain; throbbing; sensitivity come light, sounds, or smells; nausea and vomiting; blurred vision; and light-headedness and fainting.

In the may 2019 study published in Multiple Sclerosis and also Related Disorders, researchers indigenous Cedars-Sinai Medical center in Los Angeles discovered that migraine was the most typical correct diagnosis in study subjects who had actually been misdiagnosed v MS, arising in 16 percent that them.

That said, headaches — and migraines in specific — do generally occur through MS, according to a study released in April 2016 in the journal Clinical Neurology and Neurosurgery. And per a study published in march 2019 in the journal Neurologia, castle are likewise significantly associated with other species of pain, and also with depression, which is really common in world with MS.

Migraines have the right to be daunting to diagnose, and also doctors use few of the exact same tools come diagnose the headaches together they do for MS, consisting of taking a medical history and performing a thorough neurological examination.

3. Radiologically isolated Syndrome

People v radiologically isolated syndrome don’t have actually symptoms the MS, but they are discovered to have lesions on your brain, as identified by MRI, similar to those found in civilization with MS. According to the MS worldwide Federation, many however not all civilization with radiologically diverted syndrome will later build progressive MS, which is why researchers believe the condition may be very early indicator of MS.

There room no existing treatment guidelines because that radiologically secluded syndrome. Yet in the might 2019 Multiple Sclerosis and Related obstacle study, up to 10 percent of civilization misdiagnosed through — and being treated for — multiple sclerosis in truth had radiologically secluded syndrome.

4. Spondylopathies

Spondylopathies room a repertoire of disorders of the vertebrae that commonly involve inflammation. An example is ankylosing spondylitis. Symptom of these obstacle that overlap v those the MS encompass joint pain and fatigue.

In the Cedars-Sinai research reported in may 2019, as plenty of as 7 percent of ms misdiagnoses were yes, really spondylopathies.

5. Neuropathy

Neuropathy, or nerve damage, can also be misdiagnosed together MS, follow to the Cedars-Sinai study. In fact, 7 percent of human being with neuropathy in the examine were diagnosed v MS in error.

Neuropathy usually refers to “peripheral neuropathy,” or damages to the worried system exterior the brain and spinal cord (which comprise the central nervous system). Peripheral nerves attach the mind and spinal cord come the remainder of the body.

Peripheral neuropathy is particularly common in people with diabetes, due to the fact that high blood glucose levels damages the peripheral nerves.

Similar to human being with MS, civilization with neuropathy might experience loss of coordination, muscle weakness, or an obstacle walking or moving their eight or legs. However, over there are several kinds the neuropathy — sensory, motor, and also autonomic — each with their own set of symptoms, numerous of which different from the common symptoms that MS.

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6. Conversion and also Psychogenic Disorders

Conversion and also psychogenic obstacle are problems in which psychological stress is converted right into a physical difficulty — such as blindness or paralysis — because that which no medical reason can it is in found. In a study published in September 2016 in the newspaper Neurology, 11 percent of subjects absolutely or probably misdiagnosed through MS actually had actually a conversion or psychogenic disorder.

7. Neuromyelitis Optica Spectrum Disorder (NMOSD)

NMOSD is an inflammatory disease that, prefer multiple sclerosis, attacks the myelin sheaths — the protective spanning of the nerve yarn — of the optic nerves and spinal cord. But unlike MS, it usually spares the mind in its at an early stage stages. Symptom of NMOSD deserve to be similar to MS but can also include sudden vision loss or pains in one or both eyes, numbness or lose of sensation in the arms and also legs, an obstacle controlling the bladder and bowels, and uncontrollable vomiting and hiccups.

Treatments for MS room ineffective for and can also worsen NMOSD, for this reason getting an exact diagnosis is extremely important. A blood test recognized as the NMO IgG antibody test can aid to differentiate in between MS and NMOSD.

8. Lupus

Lupus is a chronic autoimmune disorder that, like MS, affects more women 보다 men. It can cause muscle pain, share swelling, fatigue, and headaches. The hallmark symptom of lupus is a butterfly-shaped rash covering the cheeks and also bridge that the nose, but only about fifty percent of human being with lupus construct this rash. There is no single diagnostic test for lupus, and also because its symptom are comparable to those of numerous other conditions, that is sometimes dubbed “the great imitator.”

Rheumatologists (physicians specializing in diseases of the muscles and also joints) typically diagnose lupus based on a number of laboratory tests and the variety of symptoms characteristics of lupus that a human being has.

9. Stroke

A punch occurs as soon as a portion of the brain stops receiving a steady supply that blood, and also consequently doesn't get the oxygen and also nutrients it needs to survive. Symptoms of a stroke normally evolve rapidly and also include ns of vision; ns of emotion in the limbs, normally on one next of the body; difficulty walking; and challenge speaking — every one of which can also be signs of an MS flare, or exacerbation.

The period of the human being experiencing the symptoms may aid to pin down the correct diagnosis. “While ms can take place in 70-year-olds, if the human being is older, you often tend to think of stroke, no MS,” Burks says. A hit requires instant attention; if friend think she experiencing a stroke, speak to 911.

10. Fibromyalgia

Fibromyalgia and MS have actually some comparable symptoms, including headaches, joint and also muscle pain, numbness and tingling of extremities, memory problems, and fatigue. Choose MS, fibromyalgia is more common in women than in men. Yet unlike MS, fibromyalgia does not present up as brain lesions on one MRI.

11. Sjögren’s Syndrome

Sjögren’s syndrome is one more autoimmune disorder, and also the symptoms of plenty of autoimmune obstacle overlap, Burks says. Sjögren’s causes fatigue and musculoskeletal pain and is much more common in ladies than in men. Yet the telltale indications are dry eyes and dry mouth, which room not associated with MS.

“Fatigue and also musculoskeletal pains are common symptoms in MS, but they’re also common symptom of a lot of other conditions,” Dr. Cohen adds.

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12. Vasculitis

Vasculitis is an inflammation the the blood vessels and may reason symptoms that have the right to mimic MS, follow to the American university of Rheumatology. Depending upon the form of vasculitis, symptoms can include pain, and also numbness, tingling, and weakness in the limbs, and cognitive problems, says Kathleen Costello, NP, a research associate at the Johns Hopkins MS facility in Baltimore and vice president of healthcare accessibility at the National lot of Sclerosis Society.

Vasculitis affect the skin or bodily organs, prefer the kidneys, have the right to be diagnosed by performing a biopsy top top samples the tissue gathered from the area. Some types of vasculitis can additionally be diagnosed by trial and error blood for the existence of antineutrophil cytoplasmic antibodies (ANCA).

13. Myasthenia Gravis

Myasthenia gravis is a chronic autoimmune condition that reasons muscle weakness that frequently comes and goes, however tends to development over time. The weak is caused by a defect in the transmission of nerve impulses to muscles. In numerous people, the very first signs of myasthenia gravis are drooping eyelids and twin vision. Prefer MS, the can additionally cause challenge with walking, speaking, chewing, and also swallowing. If a physician suspects myasthenia gravis, a variety of tests can help to confirm or preeminence out the diagnosis.

14. Sarcoidosis

Sarcoidosis is one more inflammatory autoimmune disease that shares part symptoms through MS, consisting of fatigue and also decreased vision. But sarcoidosis most generally affects the lungs, lymph nodes, and also skin, leading to a cough or wheezing, puffy lymph nodes, and lumps, sores, or locations of discoloration top top the skin.

15. Vitamin B12 Deficiency

Vitamin B12 deficiency can cause MS-like symptoms, such as fatigue, mental confusion, and numbness and tingling in the hands and also feet. That's since vitamin B12 dram a function in the line of fat acids needed to keep the myelin sheath. Vitamin B12 deficiency can be determined with a simple blood test.

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16. Acute Disseminated Encephalomyelitis (ADEM)

ADEM is a serious inflammatory attack affecting the brain and spinal cord. Symptoms include fever, fatigue, headache, nausea, vomiting, vision loss, and an obstacle walking. A really rare condition, ADEM typically come on rapidly, regularly after a famous or bacterial infection. Youngsters are more likely to have ADEM, while ms is more likely to occur in adults.