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Multiple sclerosis differential diagnosis

Manuela de Oliveira Fragomeni, Denis Bernardi Bichuetti, Enedina Maria Lobato Oliveira
BACKGROUND: Multiple Sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are acquired demyelinating syndromes of the central nervous system more frequently in young adults and their beginning before 18 years of age is rare. They are autoimmune diseases with distinct pathophysiology, clinical presentation, treatment and prognoses. During childhood these conditions often present similar clinical features and differential diagnosis among pNMOSD, pMS and acute disseminated encephalomyelitis (ADEM) is still difficult at disease onset...
July 20, 2018: Multiple Sclerosis and related Disorders
Nika Guberina, U Dietrich, A Radbruch, J Goebel, C Deuschl, A Ringelstein, M Köhrmann, C Kleinschnitz, M Forsting, C Mönninghoff
PURPOSE: New software solutions emerged to support radiologists in image interpretation in acute ischemic stroke. This study aimed to validate the performance of computer-aided assessment of the Alberta Stroke Program Early CT score (ASPECTS) for detecting signs of early infarction. METHODS: ASPECT scores were assessed in 119 CT scans of patients with acute middle cerebral artery ischemia. Patient collective was differentiated according to (I) normal brain, (II) leukoencephalopathic changes, (III) infarcts, and (IV) atypical parenchymal defects (multiple sclerosis, etc...
July 31, 2018: Neuroradiology
A Di Stadio, L Dipietro, M Ralli, F Meneghello, A Minni, A Greco, M R Stabile, E Bernitsas
OBJECTIVE: To evaluate whether Sudden Sensorineural Hearing Loss (S-SNHL) may be an early symptom of Multiple Sclerosis (MS). MATERIALS AND METHODS: A systematic review was conducted using the following keywords: "Multiple sclerosis, hearing loss, sudden hearing loss, vertigo, tinnitus, magnetic resonance imaging, otoacoustic emission, auditory brainstem responses, white matter lesions, sensorineural hearing loss, symptoms of MS and otolaryngology, nerve disease and MS"...
July 2018: European Review for Medical and Pharmacological Sciences
Pinky Jha, Sophie G Rodrigues Pereira, Abhishek Thakur, Gurdeep Jhaj, Sanjay Bhandari
INTRODUCTION: Optic neuritis is a condition associated with various systemic diseases, such as multiple sclerosis, and is also considered a rare complication of Lyme disease. CASE: A 46-year-old white woman presented with sudden onset of bilateral vision loss. After extensive workup, she was diagnosed with Lyme optic neuritis based on the clinical presentation and positive serology. She was treated with doxycycline for 2 weeks. DISCUSSION: Lyme disease is caused by infection with the spirochete Borrelia burgdorferi...
June 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
Mika Siuko, Tero T Kivelä, Kirsi Setälä, Pentti J Tienari
PURPOSE: To estimate the population-based incidence of acute idiopathic optic neuritis (ON) and analyse its differential diagnosis in patients referred with symptoms suggestive of ON. METHODS: Patients with suspected ON referred to the Helsinki University Hospital, serving a population of 1.5 million in Southern Finland, were reviewed between 1st May 2008 and 14th April 2012. Brain and optic nerve magnetic resonance imaging (MRI) was performed within 24 hours in 83% of patients...
July 24, 2018: Ophthalmic Epidemiology
Paul Jaulent, Salem Hannoun, Gabriel Kocevar, Fabien Rollot, Francoise Durand-Dubief, Sandra Vukusic, Jean-Christophe Brisset, Dominique Sappey-Marinier, Francois Cotton
BACKGROUND AND PURPOSE: Gadolinium-based contrast agents (GBCAs) administration have drastically improved the accuracy of Multiple Sclerosis (MS) diagnosis by highlighting any damage to the brain blood barrier, thereby differentiating between active and non-active lesions. Following multiple administrations of GBCAs, several MS studies have reported a signal intensity (SI) increase on unenhanced T1-weighted images in certain brain regions such as the dentate nucleus (DN) and the globus pallidus (GP)...
August 2018: European Journal of Radiology
Xiang Zhang, Hai Yu, Yu Zhang, Xiao-Ni Liu, Xue Yu, Xiang-Jun Chen
In this study, we attempted to investigate the application of RNFL thickness detection in the early differential diagnosis among various types of idiopathic optic neuritis (ION). In comparison with 19 healthy controls (HC), retrospective analysis of quadrant RNFL thickness in 83 patients with ION was performed, including eighteen multiple sclerosis (MS), forty-five neuromyelitis optica spectrum disorder (NMOSD), twenty patients with other idiopathic optic neuritis (O-ION). Our results showed that mean and every quadrant RNFL thickness of MS, NMOSD and O-ION were thinner than those of HC (P < 0...
July 11, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hak-Sun Kim, Wonae Lee, Jin-Woo Choi, Won-Jeong Han, Eun-Kyung Kim
Synovial chondromatosis is a rare metaplastic disease affecting the joints, including the temporomandibular joint (TMJ). Since its symptoms are similar to those of temporomandibular disorders, a careful differential diagnosis is essential. A 50-year-old male patient was referred with the chief complaint of pain and radiopaque masses around the left TMJ on panoramic radiography. Clinically, pre-auricular swelling and resting pain was found, without limitation of mouth opening. On cone-beam computed tomographic images, multiple calcified nodules adjacent to the TMJ and bone proliferation with sclerosis at the articular fossa and eminence were found...
June 2018: Imaging Science in Dentistry
A Kalinowska-Lyszczarz, M A Pawlak, A Pietrzak, K Pawlak-Bus, P Leszczynski, M Puszczewicz, W Paprzycki, W Kozubski, S Michalak
Differentiation of systemic lupus erythematosus (SLE) from multiple sclerosis (MS) can be challenging, especially when neuropsychiatric (NP) symptoms are accompanied by white matter lesions in the brain. Given the lack of discriminative power of currently applied tools for their differentiation, there is an unmet need for other measures that can aid in distinguishing between the two autoimmune disorders. In this study we aimed at exploring whether brain atrophy measures could serve as markers differentiating MS and SLE...
January 1, 2018: Lupus
M Jahn, H Steinberg
Paul Ferdinand Schilder was born in Vienna in 1886 and died in New York in 1940. He is nowadays remembered predominantly for his contributions to modern psychiatry and psychotherapy; however, he was also a neurologist and neuroscientist and in particular in his early years, he researched and published on neuropathological topics. This paper focuses on his scientific work during his years in Middle Germany (1909-1914), where he worked with Gabriel Anton in Halle and Paul Flechsig in Leipzig. During those years, he laid the foundations for his definition, clinical classification and differentiation of encephalitis periaxialis diffusa...
June 15, 2018: Der Nervenarzt
Frederike C Oertel, Joachim Havla, Adriana Roca-Fernández, Nathaniel Lizak, Hanna Zimmermann, Seyedamirhosein Motamedi, Nadja Borisow, Owen B White, Judith Bellmann-Strobl, Philipp Albrecht, Klemens Ruprecht, Sven Jarius, Jacqueline Palace, Maria Isabel Leite, Tania Kuempfel, Friedemann Paul, Alexander U Brandt
OBJECTIVES: Neuromyelitis optica spectrum disorders (NMOSD) are inflammatory conditions of the central nervous system and an important differential diagnosis of multiple sclerosis (MS). Unlike MS, the course is usually relapsing, and it is unclear, if progressive neurodegeneration contributes to disability. Therefore, we aimed to investigate if progressive retinal neuroaxonal damage occurs in aquaporin4-antibody-seropositive NMOSD. METHODS: Out of 157 patients with NMOSD screened, 94 eyes of 51 patients without optic neuritis (ON) during follow-up (F/U) and 56 eyes of 28 age-matched and sex-matched healthy controls (HC) were included (median F/U 2...
June 19, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Daniel Stoessel, Jan-Patrick Stellmann, Anne Willing, Birte Behrens, Sina C Rosenkranz, Sibylle C Hodecker, Klarissa H Stürner, Stefanie Reinhardt, Sabine Fleischer, Christian Deuschle, Walter Maetzler, Daniela Berg, Christoph Heesen, Dirk Walther, Nicolas Schauer, Manuel A Friese, Ole Pless
Primary progressive multiple sclerosis (PPMS) shows a highly variable disease progression with poor prognosis and a characteristic accumulation of disabilities in patients. These hallmarks of PPMS make it difficult to diagnose and currently impossible to efficiently treat. This study aimed to identify plasma metabolite profiles that allow diagnosis of PPMS and its differentiation from the relapsing-remitting subtype (RRMS), primary neurodegenerative disease (Parkinson's disease, PD), and healthy controls (HCs) and that significantly change during the disease course and could serve as surrogate markers of multiple sclerosis (MS)-associated neurodegeneration over time...
2018: Frontiers in Human Neuroscience
Shay Menascu, Carolina Legarda, Shmuel Miron, Anat Achiron
The aim was to assess brain lesion load and anatomical distribution in patients with juvenile clinically isolated syndrome and define magnetic resonance imaging (MRI) variables associated with rapidly advancing to multiple sclerosis. Patients were followed for one year after disease onset. Patients who experienced a second relapse were defined as those who rapidly advanced to multiple sclerosis. In all, 46 juvenile patients with a clinical presentation suggestive of multiple sclerosis were evaluated; 21 with gadolinium-enhancing lesions on initial brain MRI were excluded as they had already fulfilled the diagnosis criteria for multiple sclerosis...
January 1, 2018: Journal of Child Neurology
O Aktas, M P Wattjes, M Stangel, H-P Hartung
Multiple sclerosis (MS) is the most common chronic autoimmune disorder of the central nervous system (CNS) largely affecting young adults. The diagnosis of MS is based on two pillars: 1) detection of the spatial and temporal dissemination of focal neurological deficits and 2) exclusion of important differential diagnoses. The current revision of the diagnostic criteria (McDonald 2017) also follows these principles, takes new data on magnetic resonance imaging (MRI) into account and reintroduces the role of cerebrospinal fluid (CSF) diagnostics for relapsing-remitting forms...
June 6, 2018: Der Nervenarzt
Lu Wang, Hong-Jun Su, Jin-Long Qi, Rui-Fang E, Kun Zhao
Autoantibodies targeting aquaporin 4 (AQP4) water channels are a sensitive and specific biomarker for neuromyelitis optica spectrum disorder (NMOSD). Presence of AQP4 antibodies distinguishes NMOSD from multiple sclerosis. We present our experience with an anti-AQP4 antibody-positive patient diagnosed with NMOSD who complained of intractable nausea and vomiting, not restricted to optic neuritis or acute myelitis during the first attack. Her symptoms partially resolved after appropriate therapy with intravenous methylprednisolone and oral prednisolone...
January 1, 2018: Journal of International Medical Research
E Signoriello, M Cirillo, G Puoti, G Signoriello, A Negro, E Koci, M A B Melone, A Rapacciuolo, G Maresca, G Lus
OBJECTIVES: To investigate a possible association between isolated white matter lesions suggestive of demyelinating disease in magnetic resonance imaging (MRI) and patent foramen ovale (PFO) evidence in migraine patients, with or without aura. MATERIALS: 31 migraine patients, 28 females and 3 males, with MRI evidence of white matter lesions suggestive of demyelinating disease according to the Barkhof Criteria. All patients underwent further diagnostics including lumbar puncture, autoimmunity panel and cardiological evaluation to detect the presence of PFO...
July 15, 2018: Journal of the Neurological Sciences
A Ruet
Pediatric-onset multiple sclerosis (POMS) has distinctive features compared with adult-onset multiple sclerosis (AOMS), and warrants caution despite being a rare form of MS. POMS diagnostic criteria are somewhat different from those used in AOMS, with acute disseminated encephalomyelitis being a key differential diagnosis of MS in children. Other differential diagnoses that have to be ruled out before diagnosing MS include demyelinating syndromes, autoimmune and systemic pathologies, and infectious, genetic, metabolic and neoplastic diseases...
June 2018: Revue Neurologique
E Thouvenot
Multiple sclerosis (MS) is a complex heterogeneous disease. Diagnostic criteria are based on symptoms, biomarkers, MRI data and exclusion of differential diagnoses. Over the past few years, the usefulness of biomarkers has progressively decreased with the development of new MRI criteria, yet dozens of new biomarkers, especially in cerebrospinal fluid, for MS diagnosis and prognosis have been described. Large-scale studies validating some of these new biomarkers have also provided confirmation of a restricted set of biomarkers (presented here in this review) as having potential value for different stages of the disease, including as early as clinically isolated syndrome and radiologically isolated syndrome...
June 2018: Revue Neurologique
Ravinder Kumar, Abhishek Bhargava, Gagan Jaiswal, Viral R Soni, Bhoomika Katbamna, Arpit Vashisht
Purpose: Most cases of optic neuritis are idiopathic or are associated with multiple sclerosis. We present a case in which a young female developed post-infectious left optic neuritis following herpes simplex encephalitis (HSE). Case Report: A 24-year-old female presented with a severe headache, fever, and malaise of a one-week duration. Viral encephalitis was diagnosed and treated; intravenous acyclovir (750 mg every 8 h) was administered for 14 days. The patient improved clinically and was prescribed oral valacyclovir (1,000 mg, three times daily) for an additional 3 months as an outpatient...
April 2018: Journal of Ophthalmic & Vision Research
Laiyong Tu, Xinmei Liu, Wenfei Gu, Zhenbin Wang, Enfeng Zhang, Aikenmu Kahar, Ge Chu, Jiang Zhao
BACKGROUND We clarified the imaging features of Brucella spondylitis to enhance our understanding of the disease and to minimize misdiagnosis. MATERIAL AND METHODS Imaging data (X-ray, computed tomography [CT], and magnetic resonance imaging [MRI] data) of 72 Brucella spondylitis patients treated from 2010 to 2017 were retrospectively analyzed; diagnoses was made by evaluating laboratory and pathological data. RESULTS X-ray films revealed changes in intervertebral space heights, the number of lateral osteophytes, and bone destruction, which were more severe in the following order: lumbosacral vertebrae (56 cases, 77...
April 29, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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