Getting a correct diagnosis of multiple sclerosis (MS) can be a challenge. In fact, a study published in May 2019 in the journal Multiple Sclerosis and Related Disorders suggested that nearly 1 in 5 people with other neurologic conditions are mistakenly diagnosed with MS.
These errors in diagnosis likely result from the fact that there is no single test that can determine an MS diagnosis conclusively. Also, not everyone has all of the common symptoms of MS, such as numbness, tingling, pain, fatigue, and heat sensitivity. And to complicate matters, the symptoms you do have may resemble those of some other conditions.
To figure out what’s causing possible MS symptoms, doctors look at your medical history, the results of a neurological exam, and a magnetic resonance imaging (MRI) scan — and sometimes do a spinal tap (also called a lumbar puncture). To accurately diagnose MS, many other possible causes must be considered and excluded.
There are situations when it’s fairly clear that someone does — or doesn’t — have MS, says Devon Conway, MD, a neurologist at the Mellen MS Center in Cleveland. “Then sometimes there are cases where it’s a little more ambiguous; we are considering the possibility of MS but haven’t come to a definitive decision yet. Sometimes it’s necessary to observe the patient and their imaging to try to make a more definitive decision on whether they have MS or not,” says Dr. Conway.
“Misdiagnosis in MS has been an issue that’s been talked about for 40 years,” adds Jeffrey Cohen, MD, director of experimental therapeutics at the Mellen MS Center of the Cleveland Clinic in Ohio. “And even with refinement of diagnostic criteria and the availability of technologies like MRI, it’s still a problem. There are a significant number of people getting misdiagnosed with MS in part because there’s no single test for it, like a blood test.”
Conway agrees, saying, “It’s fairly common to have a misdiagnosis of MS; there’s been a fair amount of research about the need to sometimes ‘undiagnose’ patients.”
There are several conditions that may be misdiagnosed as MS, some being more likely than others.
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