Differential diagnosis

It is important not to immediately leap to a diagnosis of MS. The following should be considered:

• a structural lesion should be excluded when disease is primarily unifocal, particularly when the lesion is in the spine
  
  
• other diseases with relapsing and remitting course:
  • cerebrovascular disease
  • some cerebral tumours
  • Lyme disease
  • chronic inflammatory demyelinating polyradiculopathy
  • Sjogren's syndrome
  • Systemic lupus erythematosus
    
    
• other causes of progressive spastic paraparesis:
  • spinal cord compression
  • vitamin B12 deficiency
  • HIV myelopathy
  • HTLV-1 associated myelopathy
  • leukodystrophies
  • hereditary spastic paraparesis
    
    
• other causes of visual loss:
  • meningioma
  • Leber's atrophy
  • acute ischaemic optic neuropathy
  • toxic amblyopia
  • Friedreich's ataxia
  • neurosyphilis
  • vitamin B12 deficiency
    
    
• spinocerebellar ataxias
• CADASIL