Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 05, 2016; 86 (16 Supplement) April 16, 2016

The spectrum of multiple sclerosis misdiagnosis in the era of McDonald criteria: A multicenter study (PL01.003)

Andrew Solomon, Dennis Bourdette, Anne Cross, Angela Applebee, Philip Skidd, Diantha Howard, Rebecca Spain, Michelle Cameron, Edward Kim, Michele Mass, Vijayshree Yadav, Ruth Whitham, Erin Longbrake, Robert Naismith, Gregory Wu, Becky Parks, Dean Wingerchuk, Brian Rabin, Michel Toledano, William Tobin, Orhun Kantarci, Jonathan Carter, B. Keegan, Brian Weinshenker
First published April 4, 2016,
Andrew Solomon
8Neurological Sciences University of Vermont Burlington VT United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dennis Bourdette
5Oregon Health & Science University Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anne Cross
10Washington University School of Medicine Saint Louis MO United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Angela Applebee
7University of Vermont Burlington VT United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Philip Skidd
7University of Vermont Burlington VT United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Diantha Howard
7University of Vermont Burlington VT United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rebecca Spain
5Oregon Health & Science University Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michelle Cameron
6Portland Veterans Affairs Medical Center Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Edward Kim
5Oregon Health & Science University Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michele Mass
5Oregon Health & Science University Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vijayshree Yadav
4OHSU Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ruth Whitham
5Oregon Health & Science University Portland OR United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Erin Longbrake
10Washington University School of Medicine Saint Louis MO United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Robert Naismith
9Washington University Saint Louis MO United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gregory Wu
10Washington University School of Medicine Saint Louis MO United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Becky Parks
10Washington University School of Medicine Saint Louis MO United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dean Wingerchuk
2Mayo Clinic Scottsdale AZ United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brian Rabin
2Mayo Clinic Scottsdale AZ United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michel Toledano
1Mayo Clinic Rochester MN United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William Tobin
1Mayo Clinic Rochester MN United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Orhun Kantarci
1Mayo Clinic Rochester MN United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jonathan Carter
2Mayo Clinic Scottsdale AZ United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
B. Keegan
1Mayo Clinic Rochester MN United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Brian Weinshenker
3Mayo Clinic Dept of Neurology Rochester MN United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Citation
The spectrum of multiple sclerosis misdiagnosis in the era of McDonald criteria: A multicenter study (PL01.003)
Andrew Solomon, Dennis Bourdette, Anne Cross, Angela Applebee, Philip Skidd, Diantha Howard, Rebecca Spain, Michelle Cameron, Edward Kim, Michele Mass, Vijayshree Yadav, Ruth Whitham, Erin Longbrake, Robert Naismith, Gregory Wu, Becky Parks, Dean Wingerchuk, Brian Rabin, Michel Toledano, William Tobin, Orhun Kantarci, Jonathan Carter, B. Keegan, Brian Weinshenker
Neurology Apr 2016, 86 (16 Supplement) PL01.003;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
0

Share

  • Article
  • Info & Disclosures
Loading

Abstract

Objective: To characterize patients misdiagnosed with multiple sclerosis (MS) and hypothesize common causes for misdiagnosis. Background: Misdiagnosis of MS is a persistent if not growing problem despite, and perhaps because of, improved radiographic diagnostic techniques. Few studies have characterized the contemporary spectrum of MS misdiagnosis. Methods: Over 13 months, neurologists at four academic MS Centers submitted data concerning individual patients whom they had evaluated and determined to have been misdiagnosed with MS. Results: Of 110 misdiagnosed patients, 51 (46[percnt]) had “definite” and 59 (54[percnt]) “probable” misdiagnoses according to study definitions. The most frequent primary diagnoses were migraine alone or in combination with other diagnoses 24 (21[percnt]), fibromyalgia 16 (15[percnt]), nonspecific or non-localizing neurological symptoms with abnormal MRI 13 (12[percnt]), and conversion or psychogenic disorder 12 (11[percnt]). 27 additional diagnoses were reported. 32 (29[percnt]) of patients carried a misdiagnosis between 3-9 years and 29 (26[percnt]) for 10-20 years. 77 (70[percnt]) had taken disease modifying therapy, including natalizumab 14 (13[percnt]), mitoxantrone 2 (2[percnt]), cyclophosphamide 1 (1[percnt]). Four (4[percnt]) had participated in a research study of an MS therapy. In 79 (72[percnt]) of patients, participating neurologists indicated that there was evidence an earlier missed opportunity to make a correct diagnosis and 34 (31[percnt]) suffered unnecessary morbidity as a direct result of a misdiagnosis. Inappropriate attribution of symptoms to demyelinating disease contributed to misdiagnosis in 72 (65[percnt]) patients, and reliance upon historical symptoms without corroborating objective evidence of a lesion in 53 (48[percnt]). Over-reliance on MRI abnormalities to satisfy dissemination in space in a patient with nonspecific neurological symptoms contributed to misdiagnosis in 66 (60[percnt]). Conclusions: Misdiagnosis of MS is a common problem that may lead to treatment-related as well as psychosocial morbidity. Misinterpretation and misapplication of MS clinical and radiographic diagnostic criteria are important causes of misdiagnosis.

Disclosure: Dr. Solomon has received personal compensation from Haymarket Media as a speaker. Dr. Bourdette has received personal compensation for activities with Biogen Idec, Serono, and Teva Neurosciences as a speaker/faculty. Dr. Cross has received personal compensation for activities with Biogen Idec, Genzyme Corporation, GlaxoSmithKline, Inc., Hoffman-La Roche, Teva Neuroscience, Novartis, and Questcor. Dr. Applebee has nothing to disclose. Dr. Skidd has nothing to disclose. Dr. Howard has nothing to disclose. Dr. Spain has nothing to disclose. Dr. Michelle Cameron has received compensation for activities with Acorda therapeutics, MD consult and ReWalk as a consultant. Dr. Kim has received personal compensation for activities with Teva pharmaceutical and Genzyme. Dr. Mass has nothing to disclose. Dr. Yadav has received personal compensation for activities with Novartis as a consultant. Dr. Yadav has received research support from Biogen Idec. Dr. Whitham has received personal compensation for activities with Chugai Pharmaceutical as a data safety monitoring board member. Dr. Longbrake has received personal compensation for activities with Genzyme. Dr. Naismith received personal compensation for activities with Alkermes, Acorda, Bayer, Biogen Idec, Genentech Inc., Genzyme Corporation, EMD Serono, Novartis, and Questcor as a consultant and from Acorda Therapeutics and Genzyme Corporation as a speaker Dr. Wu has received personal compensation for activities with Biogen Idec and Pfizer Inc. Dr. Parks has received personal compensation for activities with BiogenIdec and Novartis as an advisory board member. Dr. Wingerchuk has received personal compensation for serving on a clinical trial adjudication committee for Medimmune. Dr. Wingerchuk has received personal compensation in an editorial capacity for The Neurologist. Dr. Wingerchuk has received research su Dr. Rabin has nothing to disclose. Dr. Toledano has nothing to disclose. Dr. Tobin has nothing to disclose. Dr. Kantarci has nothing to disclose. Dr. Carter has received personal compensation for activities with EMD-Serono, University of Louisville and Omnicare, Inc. for serving as a member of the board and various other activities. Dr. Carter has received research support from the Sanofi, Genzyme Dr. Keegan has received research support from Terumo BCT. Dr. Weinshenker has received personal compensation for activities with Novartis, Biogen Idec, Mitsubishi Pharmaceuticals, MedImmune Pharmaceuticals, Chugai, and Chord as a consultant. Dr. Weinshenker has received royalty payments from RSR Ltd. and Oxford

Saturday, April 16 2016, 9:00 am-11:00 am

  • Copyright © 2016 by AAN Enterprises, Inc.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: 99 (5)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise