PT  - JOURNAL ARTICLE
AU  - Solomon, Andrew J.
AU  - Bourdette, Dennis N.
AU  - Cross, Anne H.
AU  - Applebee, Angela
AU  - Skidd, Philip M.
AU  - Howard, Diantha B.
AU  - Spain, Rebecca I.
AU  - Cameron, Michelle H.
AU  - Kim, Edward
AU  - Mass, Michele K.
AU  - Yadav, Vijayshree
AU  - Whitham, Ruth H.
AU  - Longbrake, Erin E.
AU  - Naismith, Robert T.
AU  - Wu, Gregory F.
AU  - Parks, Becky J.
AU  - Wingerchuk, Dean M.
AU  - Rabin, Brian L.
AU  - Toledano, Michel
AU  - Tobin, W. Oliver
AU  - Kantarci, Orhun H.
AU  - Carter, Jonathan L.
AU  - Keegan, B. Mark
AU  - Weinshenker, Brian G.
TI  - The contemporary spectrum of multiple sclerosis misdiagnosis
AID  - 10.1212/WNL.0000000000003152
DP  - 2016 Sep 27
TA  - Neurology
PG  - 1393--1399
VI  - 87
IP  - 13
4099  - http://n.neurology.org/content/87/13/1393.short
4100  - http://n.neurology.org/content/87/13/1393.full
SO  - Neurology2016 Sep 27; 87
AB  - Objective: To characterize patients misdiagnosed with multiple sclerosis (MS).Methods: Neurologists at 4 academic MS centers submitted data on patients determined to have been misdiagnosed with MS.Results: Of 110 misdiagnosed patients, 51 (46%) were classified as “definite” and 59 (54%) “probable” misdiagnoses according to study definitions. Alternate diagnoses included migraine alone or in combination with other diagnoses 24 (22%), fibromyalgia 16 (15%), nonspecific or nonlocalizing neurologic symptoms with abnormal MRI 13 (12%), conversion or psychogenic disorders 12 (11%), and neuromyelitis optica spectrum disorder 7 (6%). Duration of misdiagnosis was 10 years or longer in 36 (33%) and an earlier opportunity to make a correct diagnosis was identified for 79 patients (72%). Seventy-seven (70%) received disease-modifying therapy and 34 (31%) experienced unnecessary morbidity because of misdiagnosis. Four (4%) participated in a research study of an MS therapy. Leading factors contributing to misdiagnosis were consideration of symptoms atypical for demyelinating disease, lack of corroborative objective evidence of a CNS lesion as satisfying criteria for MS attacks, and overreliance on MRI abnormalities in patients with nonspecific neurologic symptoms.Conclusions: Misdiagnosis of MS leads to unnecessary and potentially harmful risks to patients. Misinterpretation and misapplication of MS clinical and radiographic diagnostic criteria are important contemporary contributors to misdiagnosis.IgG=immunoglobulin G; MS=multiple sclerosis; NMOSD=neuromyelitis optica spectrum disorder; OCB=oligoclonal band