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Several conditions can mimic MS. This makes the diagnosis of MS a process of elimination. Two of these MS mimics are vitamin B12 deficiency and Lyme disease.
Vitamin B12 deficiency is discussed in the following topic.
Lyme disease can also mimic MS. However, unlike B12 deficiency, the current testing for Lyme disease is inadequate and often yields false negative results especially in chronic Lyme disease. This complicates treatment as many doctors will not treat for Lyme disease without a positive test. Dave Bexfield runs the site ActiveMSers.org. He is currently writing a book documenting his experience with chronic Lyme disease following 17 years of misdiagnosis with MS. He's publishing a new chapter every Wednesday.
When Transverse Myelitis is not Multiple Sclerosis
by Dr. Benjamin M. Greenberg
University of Texas Southwestern Medical Center
2015
Re: MS Mimics
Posted: Fri Dec 09, 2022 9:25 pm
by NHE
Bartonella is a bacterium that can be transmitted by tics, fleas, biting flies, etc. Cats are a common means of transmission, hence the illness known as cat-scratch disease. Infection with bartonella can cause symtoms that can mimic MS. Bartnella exhibits neurotropism and invades the endothelial cells of the BBB.
Cat-scratch disease is an illness caused by Bartonella henselae that occurs as a result of contact with an infected kitten or dog, such as a bite or scratch. It is more prevalent in children and young adults, as well as immunocompromised individuals. There are limited publications examining the features of CSD in patients. As such, the purpose of this research was to assess the clinical neuro-ophthalmological consequences of CSD reported in the literature. Among the ophthalmologic disorders caused by cat-scratch disease in humans, Parinaud oculoglandular syndrome, uveitis, vitritis, retinitis, retinochoroiditis and optic neuritis are the most prevalent. The neurological disorders caused by cat-scratch disease in humans include encephalopathy, transverse myelitis, radiculitis, and cerebellar ataxia. The current review addresses the neuro-ophthalmological clinical manifestations of cat-scratch disease, as described in papers published over the last four decades (1980-2022). All the data gathered were obtained from PubMed, Medline and Google Scholar. The current descriptive review summarizes the most-often-encountered clinical symptomatology in instances of cat-scratch disease with neurological and ocular invasion. Thus, the purpose of this review is to increase knowledge of cat-scratch disease's neuro-ophthalmological manifestations.
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Re: MS Mimics
Posted: Sat Dec 17, 2022 9:01 am
by NHE
Blood pressure and white matter lesions:
Quadratic relationship between systolic blood pressure and white matter lesions in individuals with hypertension J Hypertens. 2023 Jan 1;41(1):35-43.
Background: There is a well documented relationship between cardiovascular risk factors and the development of brain injury, which can lead to cognitive dysfunction. Hypertension (HTN) is a condition increasing the risk of silent and symptomatic ischemic brain lesions. Although benefits of hypertension treatment are indisputable, the target blood pressure value where the possibility of tissue damage is most reduced remains under debate.
Method: Our group performed a cross-sectional ( n = 376) and longitudinal ( n = 188) study of individuals without dementia or stroke (60% women n = 228, age 68.5 ± 7.4 years; men n = 148, age 70.7 ± 6.9 years). Participants were split into hypertensive ( n = 169) and normotensive ( n = 207) groups. MR images were obtained on a 3T system. Linear modeling was performed in hypertensive and normotensive cohorts to investigate the relationship between systolic (SBP) and diastolic (DBP) blood pressure, white matter lesion (WML), and brain volumes.
Results: Participants in the hypertensive cohort showed a quadratic relationship between SBP and WML, with the lowest amounts of WML being measured in participants with readings at approximately 124 mmHg. Additionally, the hypertensive cohort also exhibited a quadratic relationship between DBP and mean hippocampal volume; participants with readings at approximately 77 mmHg showing the largest volumes. Longitudinally, all groups experienced WML growth, despite different BP trajectories, further suggesting that WML expansion may occur despite or because of BP reduction in individuals with compromised vascular system.
Conclusion: Overall, our study suggests that in the hypertensive group there is a valley of mid-range blood pressures displaying less pathology in the brain.