Primary Progressive Multiple Sclerosis PPT.pptx

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Multiple Sclerosis - Differential Diagnosis

• The most common misconception, and one that can
  lead to an incorrect diagnosis, is that any
  attack on the central nervous system (CNS) and
  demyelination is a sign of acute multiple
  sclerosis (MS).
• There are other illnesses and disorders that can
  have symptoms similar to those of MS. Before we
  explore these differential diagnoses, let us
  first understand MS and its accompanying
  symptoms.

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What is Multiple Sclerosis?
Multiple Sclerosis is an autoimmune,
neurodegenerative and inflammatory condition
that attacks the CNS. It impairs and corrupts the
immune system and causes it to attack the bodys
own tissues. In clinical terms, MS is a
demyelinating disorder of the CNS, caused by
breakage in the myelin sheath (a thin layer
covering the axons of the neuron). When the
myelin along with the nerve fibers are attacked
and destroyed, scar tissue disrupts the
communication routes between the central nervous
system (CNS) and the rest of the body.
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Signs and symptoms of MS

• MS symptoms may vary from person to person and
  also depend on which nerve signals have been
  affected as the condition progresses.
• The most known symptoms of MS are
• Fatigue
• Abnormal sensations like numbness, tingling
• Dysesthesia (Painful sensations while carrying
  out everyday tasks)
• Allodynia (Feeling pain when you touch things
  that wouldnt ordinarily cause pain)
• Double vision or blurry vision
• Muscle issues
• Loss of bladder control
• Depression
• Cognitive impairment

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Arriving at an MS diagnosis
MS can be diagnosed by symptomatology, MRI
findings, Cerebrospinal Fluid (CSF) analysis, and
Visual Evoked Response (VER). These can help
determine how far the disorder has advanced and
can also influence further course of action. In
order to arrive at an MS diagnosis, it is
important that your physician rule out all other
kinds of disorders that exhibit similar symptoms.

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Disorders that mimic the symptoms of MS

• gt CNS infections
• CNS syphilis
• Human T Lymphotropic Virus (HTLV)
• Lyme disease
• HIV
• gt Autoimmune/inflammatory conditions
• Neuromyelitis optica spectrum disorder (NMOSD)
• Acute disseminated encephalomyelitis (ADEM)
• Myelin Oligodendrocyte Glycoprotein (MOG)-related
  demyelination
• Sjogrens Syndrome
• CNS lupus
• Sarcoidosis
• Behçets disease
• CNS vasculitis

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• gt Vascular conditions
• Small vessel disease
• Stroke
• Susac syndrome
• CADASIL
• Antiphospholipid antibody syndrome (APLAS)
• gt Metabolic conditions
• Vitamin B12 deficiency
• Copper deficiency
• Mitochondrial disease
• Leukodystrophies
• Other conditions include CNS lymphoma and
  Paraneoplastic myelopathy.

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Diagnosing MS without the requisite set of tests
can have devastating repercussions. Imagine being
treated for something you dont have while your
actual condition goes undiagnosed and untreated.