Study: MS Misdiagnosis supports improved education of Clinicians

[SNOOPY]

But diagnosing MS can be a challenge. Unlike some other illnesses, there is no specific biomarker or blood test for the disease, which is caused by a combination of genes and environmental triggers that predispose to MS. In addition, the related nerve damage can cause a wide range of symptoms, many of which are often also associated with different ailments.

A proper clinical diagnosis relies on a rigorous evaluation that includes careful interpretation of radiological data from an MRI (magnetic resonance imaging). However, MRI misinterpretation can complicate misdiagnosis. Abnormalities that resemble those of MS show up on a scan for reasons other than MS, and nonspecific abnormalities may lead to a faulty diagnosis. An overreliance on MRI abnormalities "without thoughtful consideration of history, symptoms, and neurological exam" may contribute to misdiagnosis, explains Solomon.

https://www.sciencedaily.com/release...0831163038.htm

[KoKo]

Thanks for the interesting article Snoopy.

For some reason, I had thought it was the opposite - that people were being diagnosed with other disorders, rather than being diagnosed with MS.

When I was DX'd 18 years ago, my neuro sent me to the Mellen Center for MS in Cleveland to have the specialists confirm his diagnosis (I didn't even have to ask for a second opinion).

While there, I had clinical exams by 3 neuros who specialized in MS, had all previous tests and MRI's reviewed, and had some additional rule-out tests done.

I wonder if they were just more thorough several years ago?

Take Care

[jreagan70]

For some reason, I had thought it was the opposite - that people were being diagnosed with other disorders, rather than being diagnosed with MS.

A lot of people think that. And for some of them, they think it's a conspiracy to keep people with MS from getting medical care. They never stop to consider that the gate swings both ways.

What I found most interesting is that some of the people studied were misdiagnosed with MS by MS specialists, and that some of the people misdiagnosed with MS actually participated in clinical trials for MS treatment drugs.

I think this study is a good motivation for all of us to be very careful about replying to people in limboland forums as if they are likely to -- or already have -- MS based only on what those people post in forums. Even sharing that someone with MS has the same symptoms as the undiagnosed poster can mislead them into thinking that they, too, have to have MS because they have the same symptoms as someone with MS. We surely don't want to even unintentionally encourage anyone to get fixated on, or relentlessly pursue, a diagnosis of a disease they don't actually have.

[KoKo]

A lot of people think that. And for some of them, they think it's a conspiracy to keep people with MS from getting medical care. They never stop to consider that the gate swings both ways.

What I found most interesting is that some of the people studied were misdiagnosed with MS by MS specialists, and that some of the people misdiagnosed with MS actually participated in clinical trials for MS treatment drugs.

I think this study is a good motivation for all of us to be very careful about replying to people in limboland forums as if they are likely to -- or already have -- MS based only on what those people post in forums. Even sharing that someone with MS has the same symptoms as the undiagnosed poster can mislead them into thinking that they, too, have to have MS because they have the same symptoms as someone with MS. We surely don't want to even unintentionally encourage anyone to get fixated on, or relentlessly pursue, a diagnosis of a disease they don't actually have.

Good points jreagan

I wonder if the pursuing of an MS diagnosis quickly is in part due to the strong, turned up emphasis on starting an MS treatment as early as possible (for optimum results)?

In any case, also interesting are the five common disorders mistaken for MS:

migraine
fibromyalgia
abnormal MRI with unexplained symptoms
psychological condition
neuromyelitis optica spectrum disorder

Take Care

[jreagan70]

NMO spectrum disorder being on the list isn't so surprising, since NMO and MS can act very much alike and clinicians, while not missing the presence of lesions, can misinterpret the significance of the very large lesions that are typical of NMO. Even an MS specialist who isn't familiar with NMOSD can make that mistake. The Mayo Clinic estimates that hundreds of people with NMOSD have been misdiagnosed with MS.

The one that I do find a little surprising is misdiagnosis based on a psychological condition (I'm presuming that's referring to the patient and not the doctor ). How often do we see posters in MS forums who have anxiety but negative test results who are probing for someone to agree with their own opinion that they have MS. It's a little disturbing that a medical professional could make that diagnostic error. That definitely is an indication of the need for improved education of clinicians.

[Marco]

Many suspected MS patients are often frustrated the doctors won' diagnosed them with MS or rule it out. Patients often refer to Dr. Google and are 100% certain that MS is what ails them. While no one wants to wait months or many years for an accurate diagnosis the pains caused by a misdiagnosis of MS can actually be more painful.




I would suggest patients to get 2nd opinions when it comes to life-changing diagnosis. I am not talking about about diagnosis shopping where you are trying to find a doctor that will cater to your needs, but an objective 3rd party that will sit you down and show you the MS diagnosis criteria in comparison to your chart and medical history. Many times neurologist suspect MS, but they are truly waiting for the other shoe to drop.




Using a MS Specialist versus a general neurologist can often make an immediate improvement in care. MS can be life-changing, but is often highly manageable when properly diagnosed early in the disease course.




http://www.painnewsnetwork.org/stories/2016/9/2/many-multiple-sclerosis-patients-misdiagnosed

[SNOOPY]

When I was diagnosed MS was referred to as a rare disease now MS is referred to as the most common demyelinating disease. Is MS common or are many out there with a diagnosis really misdiagnosed?

I was diagnosed under the Poser criteria. Under the newer McDonald Criteria many diagnosed years before where told MS was a misdiagnosis. The McDonald criteria was supposed to hopefully avoid a misdiagnosis. Apparently this isn't completely true...or it's not strictly adhered to, maybe both. Too quick to diagnosed? Probably.

A Psychological disorder doesn't surprise me. I have seen how Conversion Disorder/Functional Neurological Disorder can affect a person due to knowing someone for many years who has this. It is rather shocking how a Neurologist can misdiagnose this as MS.

[pennstater]

Totally agree on getting a 2nd opinion following any major diagnosis. I did, but to be honest, my neuro wanted me to go to MS clinic for 2nd opinion.

His purpose though was for me to not live in denial and to be able to accept my MS diagnosis when in remission. I am really glad he did this for the reason stated, but also it gives me reassurance I was diagnosed correctly. I have since had further reassurances: New neuro and LTD carrier neuro. Funny, small part of me was hoping they would say you were misdiagnosed!