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Differential Diagnosis


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The first requirement for a diagnosis of MS is that the presenting signs and symptoms be consistent with demyelinating disease. 

Differential diagnosis (MS mimics)

Autoimmune/inflammatory conditions

  • Neuromyelitis optica spectrum disorder (NMOSD)
  • Acute disseminated encephalomyelitis (ADEM)
  • Myelin Oligodendrocyte Glycoprotein (MOG)-related demyelination
  • Sjogren’s Syndrome
  • CNS lupus
  • Sarcoidosis
  • Behçet’s disease
  • CNS vasculitis

CNS infections

  • CNS Syphilis
  • Lyme disease
  • Human T lymphotropic virus (HTLV)
  • HIV

Metabolic conditions

  • Vitamin B12 deficiency
  • Copper deficiency
  • Mitochondrial disease
  • Leukodystrophies

Vascular conditions

  • Small vessel disease
  • Stroke
  • Susac syndrome
  • Antiphospholipid antibody syndrome (APLAS)


  • CNS lymphoma
  • Paraneoplastic myelopathy



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