differential diagnosis

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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

Last reviewed 11/2020

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