engleski

The differential diagnosis of multiple sclerosis

The diagnosis of multiple sclerosis must remain a clinical one, supported but not supplanted by magnetic resonance imaging. Reliance on the multile sclerosis as the principal if not exclusive basis forthe diagnosis leads to error in as many as one third of cases. The differential diagnosis of multiple sclerosis is most difficult at the onset of the disease, the most commonly encountered challenge being to determine if the symptoms are those of the first bout of MS or a single episode of acute disseminated encephalo.myelitis. various forms ov vasculitis may be indeed very difficult to separate from MS, as well as various causes of retrobulbar neuritis, and transverzal myelitis. In combination with clinical evaluation the judicious interpretation of the results of MRI and CSF analysis can make important contributions in reaching the correct diagnosis of MS. Unfortunately, the uncritical interpretation of the MRI may lead to an erroneus diagnosis of MS, especially in patients with atypical clinical symptoms. Although the clinical presentation of MS can be perplexing to even the most astute neurologist, confirmation of the diagnosis should be the province of those who are experienced in dealing with the disease.

Differential diagnosis; Encephalomyellitis; MRI; Vasculitides

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