Diagnosing MS frequently requires judgment out various other feasible conditions with equivalent symptoms.Stuart Kinlough/Getty Images
Getting a correct diagnosis of multiple sclerosis (MS) can be an obstacle. In fact, a research publiburned in May 2019 in the journal Multiple Sclerosis and also Related Disorders said that virtually 1 in 5 world with various other neurologic problems are incorrectly diagnosed through MS.

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These errors in diagnosis most likely outcome from the fact that tright here is no single test that can determine an MS diagnosis conclusively. Also, not everyone has every one of the common symptoms of MS, such as numbness, tingling, pain, exhaustion, and warm sensitivity. And to complicate matters, the symptoms you execute have may resemble those of some other conditions.

To figure out what’s resulting in possible MS symptoms, doctors look at your clinical background, the results of a neurological exam, and an MRI — and also periodically execute a spinal tap (additionally dubbed a lumbar puncture), says Jack Burks, MD, a neurologist and also chief clinical officer for the Multiple Sclerosis Association of America. "The diagnosis can likewise call for eliminating the possible MS mimicker conditions," he states. That leads to an MS diagnosis by exclusion.

“Misdiagnosis in MS has actually been an issue that’s been talked around for 40 years,” adds Jeffrey Cohen, MD, director of experimental therapeutics at the Mellen MS Center of the Cleveland also Clinic in Ohio. “And even via refinement of diagnostic criteria and also the availcapacity of innovations like MRI, it’s still a difficulty. Tbelow are a far-reaching variety of human being getting misdiagnosed with MS in part because there’s no single test for it, choose a blood test.”

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Here are some of the conditions that are sometimes mistaken for multiple sclerosis:

1. Lyme Disease

Lyme disease is a bacterial infection transmitted through a tick bite. Early symptoms include fatigue, fever, headaches, and also muscle and joint aches. Later symptoms can include numbness and also tingling in the hands and also feet, and cognitive difficulties, such as short-lived memory loss and speech problems. If you live in a space that’s well-known to have Lyme disease or have actually recently travecaused one, your medical professional will want to dominion out the opportunity, Dr. Burks claims.


2. Migraine

A migraine is a form of headache that have the right to cause intense pain; throbbing; sensitivity to light, sounds, or smells; nausea and also vomiting; blurred vision; and light-headedness and fainting.

In the May 2019 study published in Multiple Sclerosis and also Related Disorders, researchers from Cedars-Sinai Medical Center in Los Angeles found that migraine was the the majority of widespread correct diagnosis in examine topics that had been misdiagnosed with MS, arising in 16 percent of them.

That shelp, headaches — and migraines in certain — do generally happen through MS, according to a examine published in April 2016 in the journal Clinical Neurology and also Neurosurgery. And per a research publimelted in March 2019 in the journal Neurologia, they are likewise substantially linked with other forms of pain, and also via depression, which is incredibly widespread in civilization via MS.

Migraines can be challenging to diagnose, and physicians usage some of the exact same tools to diagnose the headaches as they perform for MS, consisting of taking a clinical history and perdeveloping a thoturbulent neurological examination.

3. Radiologically Isolated Syndrome

People through radiologically isolated syndrome don’t have actually symptoms of MS, however they are found to have lesions on their brain, as identified by MRI, similar to those found in world with MS. According to the MS Internationwide Federation, many kind of however not all people through radiologically isolated syndrome will later develop gradual MS, which is why researchers think the condition might be an early indicator of MS.

Tright here are no existing treatment guidelines for radiologically isolated syndrome. But in the May 2019 Multiple Sclerosis and Related Disorders study, up to 10 percent of human being misdiagnosed via — and also being treated for — MS in truth had actually radiologically isolated syndrome.

4. Spondylopathies

Spondylopathies are a arsenal of disorders of the vertebrae that generally involve inflammation. An instance is ankyshedding spondylitis. Symptoms of these disorders that overlap through those of MS incorporate joint pain and also fatigue.

In the Cedars-Sinai research study reported in May 2019, as many as 7 percent of MS misdiagnoses were really spondylopathies.

5. Neuropathy

Neuropathy, or nerve damages, deserve to additionally be misdiagnosed as MS, according to the Cedars-Sinai study. In fact, 7 percent of human being through neuropathy in the research were diagnosed via MS in error.

Neuropathy generally refers to “peripheral neuropathy,” or damage to the nervous device exterior the brain and also spinal cord (which consist of the main nervous system). Peripheral nerves attach the brain and spinal cord to the remainder of the body.

Peripheral neuropathy is especially common in human being through diabetes, because high blood glucose levels damage the peripheral nerves.

Comparable to people via MS, human being with neuropathy might suffer loss of coordicountry, muscle weakness, or challenge walking or moving their arms or legs. However, tright here are numerous kinds of neuropathy — sensory, motor, and autonomic — each via their own collection of symptoms, many kind of of which differ from the common symptoms of MS.

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6. Convariation and Psychogenic Disorders

Conversion and also psychogenic disorders are conditions in which mental tension is converted right into a physical problem — such as blindness or paralysis — for which no clinical cause can be uncovered. In a study published in September 2016 in the journal Neurology, 11 percent of subjects certainly or more than likely misdiagnosed via MS actually had actually a conversion or psychogenic disorder.

7. Neuromyelitis Optica Spectrum Disorder (NMOSD)

NMOSD is an inflammatory disease that, prefer multiple sclerosis, strikes the myelin sheaths — the protective spanning of the nerve fibers — of the optic nerves and also spinal cord. But unprefer MS, it typically spares the brain in its beforehand stages. Symptoms of NMOSD can be comparable to MS however deserve to likewise include sudden vision loss or pain in one or both eyes, numbness or loss of sensation in the arms and legs, difficulty controlling the bladder and also bowels, and also unmanageable vomiting and also hiccups.

Treatments for MS are ineffective for and have the right to also worsen NMOSD, so gaining an exact diagnosis is very vital. A blood test known as the NMO IgG antibody test can help to identify between MS and also NMOSD.

8. Lupus

Lupus is a chronic autoimmune disorder that, favor MS, affects even more woguys than men. It can cause muscle pain, joint swelling, fatigue, and also headaches. The hallmark symptom of lupus is a butterfly-shaped rash extending the cheeks and also bridge of the nose, yet only around half of civilization via lupus construct this rash. Tright here is no single diagnostic test for lupus, and because its symptoms are equivalent to those of many other problems, it is occasionally referred to as “the excellent imitator.”

Rheumatologists (medical professionals specializing in diseases of the muscles and also joints) commonly diagnose lupus based upon a number of laboratory tests and the number of symptoms characteristic of lupus that a perchild has.

9. Stroke

A stroke occurs when a part of the brain stops receiving a steady supply of blood, and consequently doesn't get the oxygen and nutrients it demands to survive. Symptoms of a stroke mostly evolve quickly and also encompass loss of vision; loss of feeling in the limbs, typically on one side of the body; difficulty walking; and obstacle speaking — every one of which have the right to likewise be indicators of an MS flare, or exacerbation.

The age of the perboy enduring the symptoms may assist to pin dvery own the correct diagnosis. “While MS can occur in 70-year-olds, if the perboy is older, you tfinish to think of stroke, not MS,” Burks states. A stroke needs immediate attention; if you think you’re experiencing a stroke, speak to 911.

10. Fibromyalgia

Fibromyalgia and MS have actually some equivalent symptoms, consisting of headaches, joint and also muscle pain, numbness and also tingling of extremities, memory troubles, and also tiredness. Like MS, fibromyalgia is more widespread in woguys than in males. But unlike MS, fibromyalgia does not display up as brain lesions on an MRI.

11. Sjögren’s Syndrome

Sjögren’s syndrome is an additional autoimmune disorder, and the symptoms of many autoimmune disorders overlap, Burks claims. Sjögren’s reasons fatigue and musculoskeletal pain and is more common in woguys than in men. But the telltale indications are dry eyes and also dry mouth, which are not associated via MS.

“Fatigue and also musculoskeletal pain are common symptoms in MS, however they’re likewise prevalent symptoms of a lot of other problems,” Dr. Cohen adds.

RELATED: Advances in Diagnosing MS

12. Vasculitis

Vasculitis is an inflammation of the blood vessels and also might reason symptoms that have the right to mimic MS, according to the Amerideserve to College of Rheumatology. Depending on the kind of vasculitis, symptoms have the right to incorporate pain, and numbness, tingling, and weakness in the limbs, and also cognitive problems, says Kathleen Costello, NP, a research associate at the Johns Hopkins MS Center in Baltimore and vice president of healthtreatment accessibility at the National Multiple Sclerosis Society.

Vasculitis affecting the skin or bodily organs, favor the kidneys, have the right to be diagnosed by perdeveloping a biopsy on samples of tproblem accumulated from that area. Some types of vasculitis deserve to additionally be diagnosed by testing blood for the visibility of antineutrophil cytoplasmic antibodies (ANCA).

13. Myasthenia Gravis

Myasthenia gravis is a chronic autoimmune illness that causes muscle weakness that generally comes and goes, yet tends to progress over time. The weakness is caused by a defect in the transmission of nerve impulses to muscles. In many human being, the first signs of myasthenia gravis are drooping eyelids and double vision. Like MS, it have the right to likewise cause challenge via walking, speaking, chewing, and swpermitting. If a doctor suspects myasthenia gravis, a number of tests have the right to assist to confirm or dominance out the diagnosis.

14. Sarcoidosis

Sarcoidosis is one more inflammatory autoimmune condition that shares some symptoms with MS, including tiredness and also diminished vision. But sarcoidosis most typically affects the lungs, lymph nodes, and skin, resulting in a cough or wheezing, swollen lymph nodes, and lumps, sores, or areas of discoloration on the skin.

15. Vitamin B12 Deficiency

Vitamin B12 deficiency can cause MS-favor symptoms, such as exhaustion, psychological confusion, and numbness and tingling in the hands and feet. That's because vitamin B12 plays a duty in the metabolism of fatty acids required to keep the myelin sheath. Vitamin B12 deficiency have the right to be determined via a basic blood test.

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16. Acute Disseminated Encephalomyelitis (ADEM)

ADEM is a severe inflammatory strike affecting the brain and also spinal cord. Symptoms incorporate fever before, tiredness, headache, nausea, vomiting, vision loss, and also difficulty walking. A exceptionally rare condition, ADEM frequently comes on swiftly, regularly after a viral or bacterial infection. Children are more most likely to have ADEM, while MS is even more likely to happen in adults.