Differential diagnosis of MS - very extensive list

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Differential diagnosis of MS - very extensive list

Postby HappyPoet » Sat Mar 02, 2013 5:47 am

Differential diagnosis of MS - most extensive list I've ever found:

http://www.medmerits.com/index.php/arti ... lerosis/P8
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Re: Differential diagnosis of MS - very extensive list

Postby euphoniaa » Sun Mar 03, 2013 8:24 am

HappyPoet wrote:Differential diagnosis of MS - most extensive list I've ever found:

http://www.medmerits.com/index.php/arti ... lerosis/P8

Thanks, Poet. It's good to keep reminding newcomers (and even us long-time MSers) that MS shares symptoms with many, many other medical conditions, especially neurological ones. And also, even with an MS diagnosis, it's not always to blame for our complaints.

Lots of us, like me, are plagued by additional diagnoses that can cause as many of our problems as MS! One of mine isn't on the list - HNPP - but its sister diagnosis is listed (Charcot-Marie-Tooth disease). They are both hereditary peripheral neuropathies with issues on the same gene (CMT a duplication and HNPP a deletion).

In fact, with me, it's absolutely impossible to identify which symptom comes from which medical condition on which day. :smile: Seriously. Among other medical conditions, I have demyelinating diseases of both the Central & Peripheral Nervous Systems (MS and HNPP) as well as spinal damage that shows on my MRIs (spondylosis & arthritis). Or they're just due to age, and I appear to be aging rapidly. :smile:

So to newcomers - an MS diagnosis doesn't necessarily give you all the answers. Keep an open mind and try to keep yourself healthy overall! And remember, it's not always MS, it's not always MS, it's not always MS...
Dx'd with MS & HNPP (hereditary peripheral neuropathy) 7/03 but must have had MS for 30 yrs before that. I've never taken meds for MS except 1 yr experiment on LDN. (I found diet, exercise, sleep, humor, music help me the most.)
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Re: Differential diagnosis of MS - very extensive list

Postby blossom » Sun Mar 03, 2013 8:32 pm

i'd venture to say once there are lesions seen or a couple other things they test for more than likely not much else is considered in most patients. one of the things listed is quote: under things that can be confused with ms

•Cervical compression (disc, spondylosis, or tumor) can cause a progressive paraparesis, gait disorder, and bladder dysfunction


that's me symptoms fit add heat intolerence-but my thoughts as blood flow and csf flow become more comprimised because the spine just keeps getting worse effecting this also.
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Re: Differential diagnosis of MS - very extensive list

Postby ljelome » Tue Mar 05, 2013 10:29 pm

Thank u happypoet, ur information is very precious for me n for others too.

Postinfectious and postvaccinal encephalomyelitis follow inflammation-induced sensitization to myelin antigens. These reactions cause inflammatory demyelination that is localized (eg, transverse myelitis, optic neuritis) or diffuse (eg, encephalomyelitis). Symptoms often develop after upper respiratory tract infections (usually viral or mycoplasma) or vaccinations, leading to acute disseminated encephalomyelitis. Oligoclonal bands in CSF are less common than in multiple sclerosis and, if present, often disappear. MRI lesions should all be of the same age, but several weeks after onset, partially-resolved lesions can appear to be different ages. The perivascular inflammation and demyelination is similar to the pathology of multiple sclerosis, but these fever-associated disorders are monophasic (Tselis and Lisak 1995).

I did often suffer from upper respiratory tract infections since my childhood.

CADASIL, Binswanger disease, hemiplegic migraine, Sjögren syndrome, and Behçet disease can cause episodic, multifocal central nervous system lesions that can be confused with multiple sclerosis clinically and on MRI.
.....
“Phenocopies” of multiple sclerosis appear on MRI scans. CADASIL, hypertensive vascular disease, Susac syndrome, leukodystrophies, vanishing white matter disease, Alexander disease, sarcoid, and migraine all overlap with the MRI appearance of multiple sclerosis.

Does it mean that other diseases could result in the same clinical picture as MS (lesions found with MRI)?

Multiple sclerosis eventually develops in 20% to 33% of ADEM patients. Thus, most patients with ADEM (66% to 80%) do not develop multiple sclerosis and should not be treated for multiple sclerosis when oligoclonal bands are negative.

How many pwMS that could've been misdiagnosed n treated with the wrong drugs?

Amyloid angiopathy causes cerebral microhemorrhages but also a leukoencephalopathy that involves the U-fibers. Iron in lesions can be seen on T2*-weighted MRI.

Similar to the CCSVI theory?

Copper deficiency causes a progressive myelopathy and neuropathy, often related to gastrointestinal disorders, post-gastric bypass, and zinc excess (similar to the cuprizone model in rodents).
...Folate deficiency can cause encephalopathy and spastic paraparesis.
...Vitamin B12 deficiency causes subacute combined degeneration with centrocecal scotomata, optic atrophy, MRI lesions around the corpus callosum (not Dawson fingers), partially reversible leukoencephalopathy, and long tract signs from cord degeneration.
Vitamin E deficiency causes ataxia, myelopathy, and neuropathy

For those who interested in nutrition deficiency? Maybe it could explain why diet works for some and not for others?

Devic disease, or neuromyelitis optica, is a demyelinating, sometimes necrotic, inflammatory disease of the spinal cord and the optic nerves. Attacks are more severe and more frequent than in multiple sclerosis. In Asia and South America and in Native American Indians, Devic disease is more common than multiple sclerosis. In Europe and the United States, multiple sclerosis is far more common.
.....Rituximab was therapeutic in a series of 8 patients (Cree et al 2005). Plasmapheresis may also reduce symptoms. Interferon therapy, however, may cause worsening (Javed and Reder 2006; Wang et al 2006; Warabi et al 2007), but because this disease is so active, apparently adverse interferon effects could be spurious (Javed 2011).

Maybe that explains why a drug works for some and not for others?

Inflammatory bowel disease with brain lesions.

I have bowel problem, how to differentiate this from MS?

Parasites can migrate into the CNS and cause focal symptoms and must be excluded in patients from endemic areas, eg, cysticercosis.

But not all parasites are bad for us, helminths for example?

Cancer--primary and secondary brain tumors. Hemophagocytic lymphohistiocytosis, Langerhans cell histiocytosis, and neoplastic angioendotheliosis can be confused with multiple sclerosis.
....Storage disorders and other genetic diseases versus childhood multiple sclerosis. Leukodystrophies are usually confluent and bilateral on MRI. Juvenile metachromatic leukodystrophy and late onset Tay-Sachs disease have MRI signatures that could be confused with multiple sclerosis. Also to be considered are adult polyglucosan body disease (glycogen-branching enzyme mutation causes accumulation of polyglucosan bodies throughout the nervous system and cerebral myelin loss),....

Dear lyndacarol, maybe this has something to do with your theory?

Susac syndrome. Retrobulbar vasculopathy of Susac causes encephalopathy, branch (distal) retinal artery occlusions, and hearing loss (Weinshenker and Lucchinetti 1998). It affects 20- to 40-year-old women and is associated with headaches, hearing loss, tinnitus, pseudobulbar speech, and encephalopathy. There are microangiopathic infarcts in gray and white matter, and bilateral branch artery occlusions in the retina. MRI shows many multifocal white matter lesions of the central corpus callosum, plus lesions in deep gray, posterior fossa, brain parenchyma, and occasionally the leptomeninges. Acute large “snowballs” and multiple older small “punched-out” areas riddle the central corpus callosum (Susac et al 2003). Intravenous immunoglobulin and corticosteroids improve hearing and MRI.

I read somewhere about someone who had tinnitus...what is tinnitus?(pardon my question)

Vaccination (polio and possibly influenza). Associations reported in a few papers are likely spurious, as the vast majority of studies find no link. Some find a 3-fold increase in the incidence of multiple sclerosis after vaccination with recombinant hepatitis B vaccine, but not with vaccines against other viruses (Hernan et al 2004), yet others report no increase.

I had hepatitis B vaccination for couple of times.

Viruses or viral encephalitis (measles, mumps, rubella, chickenpox, cytomegalovirus, hepatitis A and B, herpes zoster vasculopathy, HHV-6 encephalomyelitis, acute HIV infection, HTLV-I (also associated with Sjögren syndrome), infectious mononucleosis, Japanese encephalitis (a flavivirus with bilateral thalamic lesions and polio-like flaccid paralysis), post-measles autoimmunity and subacute sclerosing panencephalitis, poliomyelitis (central cord lesions on MRI), West Nile virus (flavivirus) with a polio-like presentation. Japanese macaque encephalitis causes multifocal inflammatory demyelinating plaques of varying ages. It is caused by a gamma-2 herpesvirus with 50% homology to human Kaposi sarcoma-associated virus.

I had rubella, measles and herpes.

Would it be better to know what disease we have first, then we could use the right treatment to address the real issues?
I really need doctor House's team to examine me...hahaha
Warm regards,
Linda

|For the joy of the Lord is your strength | A cheerful heart is good medicine, but a crushed spirit dries up the bones| God always leads us to where we need to be, not where we want to be|
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Re: Differential diagnosis of MS - very extensive list

Postby lyndacarol » Wed Mar 06, 2013 7:41 pm

Linda,

I thank you for thinking of me with the mention of Langerhans cell histiocytosis. I do not see the direct link to my theory.

Tinnitus is also called "ringing in the ears."
My hypothesis: excess insulin (hyperinsulinemia) plays a major role in MS, as developed in my initial post: http://www.thisisms.com/forum/general-discussion-f1/topic1878.html "Insulin – Could This Be the Key?"
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Re: Differential diagnosis of MS - very extensive list

Postby ljelome » Thu Mar 07, 2013 11:49 pm

Dear lyndacarol,
You did read the whole article, didn't u? Beside Langerhans cell histiocytosis, there's other thing about glycogen n adult polyglucosan disease....
Also to be considered are adult polyglucosan body disease (glycogen-branching enzyme mutation causes accumulation of polyglucosan bodies throughout the nervous system and cerebral myelin loss),....

I just quoted part of it.

Hope it could help u with ur theory.
Thank u.
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Re: Differential diagnosis of MS - very extensive list

Postby ljelome » Thu Mar 07, 2013 11:55 pm

Dear HappyPoet,
May i use ur article or link to the article for my blog?
U know what? One of my MS friend here, just got diagnosed with devic disease, because her symptoms is more likely to be Devic and not MS.
I think every pwMS should know that other diseases could have similar symptoms and lesions like MS. So by then, they can get the right treatment.
Thank u.
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