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EHS

Misdiagnosis of multiple sclerosis: If you have a hammer, everything looks like a nail?


Misdiagnosis of multiple sclerosis (MS) is an important contemporary issue in neurologic practice. MS specialist neurologists commonly encounter patients who have been misdiagnosed with MS, sometimes over periods of 10 years or more.1 A large number of rare genetic, metabolic, vascular, and inflammatory disorders are often discussed in the differential diagnosis of MS.2 However, the conditions most often mistaken for MS are commons ones—migraine, fibromyalgia, and functional neurologic disorders, typically when MRI scans done to investigate these problems disclose white matter lesions.1 Misdiagnosis of MS can have serious implications: patients may be exposed to the risks of MS disease-modifying therapies; treating neurologists may face medicolegal claims and litigation; and already stretched health care systems carry the financial burden of unnecessary disease-modifying therapy prescription and monitoring.

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