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Multiple sclerosis differential diagnosis

Barry Wolf
BACKGROUND: Multiple sclerosis is a disorder of the central and peripheral nervous system of young and old adults that is characterized by muscle, coordination and vision abnormalities. Multiple sclerosis is likely due to numerous causes. METHODS: Recently, adolescents and adults with ophthalmological and or neurological findings have been diagnosed with biotinidase deficiency. These individuals have exhibited myelopathy, paresis and/or spastic diplegia/tetraplegia with or without optic neuropathy/vision loss...
November 28, 2018: Multiple Sclerosis and related Disorders
Jessica D Forbes, Chih-Yu Chen, Natalie C Knox, Ruth-Ann Marrie, Hani El-Gabalawy, Teresa de Kievit, Michelle Alfa, Charles N Bernstein, Gary Van Domselaar
BACKGROUND: Immune-mediated inflammatory disease (IMID) represents a substantial health concern. It is widely recognized that IMID patients are at a higher risk for developing secondary inflammation-related conditions. While an ambiguous etiology is common to all IMIDs, in recent years, considerable knowledge has emerged regarding the plausible role of the gut microbiome in IMIDs. This study used 16S rRNA gene amplicon sequencing to compare the gut microbiota of patients with Crohn's disease (CD; N = 20), ulcerative colitis (UC; N = 19), multiple sclerosis (MS; N = 19), and rheumatoid arthritis (RA; N = 21) versus healthy controls (HC; N = 23)...
December 13, 2018: Microbiome
Marcel Gebhardt, Peter Kropp, Frank Hoffmann, Uwe K Zettl
Multiple sclerosis (MS) is the most common immune-mediated inflammatory disease of the central nervous system (CNS). Early diagnosis and treatment is important to prevent progression of disability in the course of the chronic disease. Therefore, correct and fast identification of early symptoms is vital. Headache is generally not recognized as an early symptom of MS, although numerous studies could show a high prevalence of headache in MS patients. The most common misdiagnosis is migraine. The aim of this study is to investigate the prevalence as well as the phenomenology of headache in MS especially with regard to the progression of the disease...
November 30, 2018: Journal of Neural Transmission
Athina Papadopoulou, Frederike Cosima Oertel, Hanna Zimmermann, Oliver Zeitz, Alexander U Brandt, Friedemann Paul
Retinal changes and visual symptoms are present in several inflammatory, degenerative and tumorous disorders of the central nervous system (CNS). Optical coherence tomography (OCT) is a method that can be used in clinical practice to detect and quantify the structural correlates of these visual symptoms in neurological disorders. OCT is a non-invasive imaging technique, based on interferometry, which can create high-resolution images of the retina and measure the thickness and volume of the different retinal layers...
November 2018: Klinische Monatsblätter Für Augenheilkunde
C Saade, R Bou-Fakhredin, D M Yousem, K Asmar, L Naffaa, F El-Merhi
The pathogenesis of multiple sclerosis is characterized by a cascade of pathobiologic events, ranging from focal lymphocytic infiltration and microglia activation to demyelination and axonal degeneration. MS has several of the hallmarks of an inflammatory autoimmune disorder, including breakdown of the BBB. Gadolinium-enhanced MR imaging is currently the reference standard to detect active inflammatory lesions in MS. Knowledge of the patterns and mechanisms of contrast enhancement is vital to limit the radiologic differential diagnosis in the staging and evaluation of MS lesion activity...
November 1, 2018: AJNR. American Journal of Neuroradiology
Marcel Gebhardt, Peter Kropp, Frank Hoffmann, Uwe K Zettl
AIMS: Headaches have not been considered a typical symptom of multiple sclerosis (MS), although since 2000, almost every study showed high prevalence. We screened 50 MS patients at the time of first occurrence of neurological symptoms and found the highest prevalence of headache in MS that was ever recorded (78%). Postmortem histological analyses of MS patients' brains revealed lymphoid follicle-like structures in the cerebral meninges and a pathophysiological link between headache, and high inflammatory activity especially in the initial phase of MS could be suspected...
October 26, 2018: European Neurology
Franca Wagner, Lorenz Grunder, Arsany Hakim, Nicole Kamber, Michael P Horn, Julia Muellner, Robert Hoepner, Roland Wiest, Imke Metz, Andrew Chan, Anke Salmen
Objective: Differential diagnosis of neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) or mimics can be challenging, especially in patients with atypical presentations and negative serostatus for aquaporin-4 antibodies (AQP4-Ab). This brief research report describes magnetic resonance imaging (MRI) findings focusing on quantitative apparent diffusion coefficient (ADC) histogram analysis as a potential tool to differentiate NMOSD from MS. Methods: Longitudinal MRI data obtained during routine clinical examinations were retrospectively analyzed in a patient with histologically determined cerebral NMOSD, a patient with an acute tumefactive MS lesion, and a patient with ischemic stroke...
2018: Frontiers in Neurology
Benjamin Marshall Davies, Colin Fraser Munro, Mark Kotter
BACKGROUND: Degenerative Cervical Myelopathy (DCM) is a common debilitating condition resulting from degeneration of the cervical spine. Whilst decompressive surgery can halt disease progression, existing spinal cord damage is often permanent, leaving patients with lifelong disability. Early surgery improves the likelihood of recovery, yet the average time from onset of symptoms to correct diagnosis is over 2 years. The majority of delays occur initially, before and within primary care, mainly due to a lack of recognition...
July 30, 2018: Journal of Medical Internet Research
Christian Blume, Izabela Tuleta, Kay Nolte, Klaus W Eichhorn, Mark Jakob, Hans Clusmann, Thorsten Send
OBJECTIVE: Sarcoidosis is a multisystemic granulomatous disease of unknown cause which affects the lung or bilateral hilar lymphadenopathy in over 90% of the cases. Neurosarcoidosis (NS) is rare and accounts for approximately 5 - 15% of the cases. Involvement of all parts of the central and peripheral nervous system is possible with various clinical symptoms, e. g. seizures, hydrocephalus, optic/facial nerve palsy or hearing loss. METHODS: We screened the neuropathological data bases and the medical records of two neurosurgical university hospitals for cases of NS...
October 8, 2018: British Journal of Neurosurgery
Marina Vasilj, Vanja Basic Kes, Nada Vrkic, Ines Vukasovic
OBJECTIVE: The objective of the research was to evaluate diagnostic and predictive value for determination of KFLC in cerebrospinal fluid (CSF) compared to the qualitative procedure of OCB determination in patients with CIS who converted to MS during a two-year period. PATIENTS AND METHODS: KFLC, total immunoglobulin G (IgG), serum albumin and CSF albumin were determined with an immunonephelometric method in 151 patients with suspected MS who were admitted to the Neurology Clinic while CSF/serum quotients (QKFLC, QIgG and QAlb) and indexes were calculated with regards to albumin (QCSF/Qserum)...
November 2018: Clinical Neurology and Neurosurgery
Lorenzo Ugga, Sirio Cocozza, Giuseppe Pontillo, Camilla Russo, Vincenzo Brescia Morra, Roberta Lanzillo, Eleonora Riccio, Antonio Pisani, Arturo Brunetti
BACKGROUND AND PURPOSE: Multiple Sclerosis (MS) has been proposed as a possible differential diagnosis with Fabry Disease (FD). We evaluated the incidence of infratentorial lesions in FD patients, investigating whether their presence could help in differentiating these two conditions. We explored the diagnostic accuracy of this sign alone and in combination to the involvement of corpus callosum (CC). METHODS: White Matter lesions were retrospectively evaluated on FLAIR images available from 136 MS and 144 FD patients...
November 2018: Brain and Behavior
Camilla Russo, Eleonora Riccio, Giuseppe Pontillo, Sirio Cocozza, Enrico Tedeschi, Diego Centonze, Antonio Pisani
BACKGROUND: Multiple Sclerosis (MS) is considered among possible differential diagnosis of Fabry Disease (FD), especially in early stages when findings are suggestive but not diagnostic for MS. We report the case of a family in which FD and MS coexist, offering an overview on clues for differential diagnosis and speculating on shared etiopathogenic mechanisms for these conditions. METHODS: Taking as starting point the diagnosis of FD in a dialysis patient during a screening programme, we retrospectively rebuilt his family history and revised clinical and imaging examinations of his five siblings, two of which with previous diagnosis of MS...
September 19, 2018: Multiple Sclerosis and related Disorders
Soniza Vieira Alves-Leon, Monique da Rocha Lima, Priscila Conrado Guerra Nunes, Leila Maria Cardão Chimelli, Kíssila Rabelo, Rita Maria Ribeiro Nogueira, Fernanda de Bruycker-Nogueira, Elzinandes Leal de Azeredo, Paulo Roberto Bahia, Fernanda Cristina Rueda Lopes, Jorge P Barreto Marcondes de Souza, Fabrícia Lima Fontes-Dantas, Marciano Viana Paes, Elba Rs Lemos, Flavia Barreto Santos
BACKGROUND: A range of different neurological manifestations has been reported in fetuses and adults after Zika virus (ZIKV) infection. OBJECTIVE: We describe a detection of the ZIKV in the brain tissue from a multiple sclerosis (MS) patient with acute disseminated encephalomyelitis (ADEM)-like event in Rio de Janeiro, Brazil. METHODS: Biological samples collected during the hospitalization were tested by serology and molecular diagnostic for various infectious agents...
June 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
C Trebst, T Kümpfel
Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are chronic inflammatory diseases of the central nervous system (CNS). They may cause inflammation in the brain, spinal cord and optic nerve. Both conditions must be differentiated from CNS manifestations of other systemic autoimmune diseases such as systemic lupus erythematosus (SLE), Sjögren's syndrome, autoinflammtory diseases and sarcoidosis, since amongst others myelitis and optic nerve inflammation may also occur in these conditions...
October 2018: Der Nervenarzt
S A Sivertseva, O V Bykova, K Z Bakhtiyarova, A M Prilenskaya, M Yu Sivertsev, N S Kandala, D V Bazhukhin, N F Smirnova, M E Guseva, A N Boyko
The careful differential diagnosis is very important in pediatric cases of multiple sclerosis (MS). It has special difficulties, if MS started in patients with residual neurological pathology. Two cases of development of MS in children with cerebral palsy (CP) are presented. The clinical features and diagnostic difficulties in such comorbid situations are discussed .
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Uri Givon, Chen Hoffman, Alon Friedlander, Anat Achiron
PURPOSE: The difficult differentiation between multiple sclerosis (MS) lesions and cervical spondylotic myelopathy (CSM) in the cervical spine is well known. The magnetic resonance imaging (MRI) appearance of both lesions is similar, and clinical parameters are usually used for diagnosis. The objective was to establish a reliable radiologic paradigm for diagnosis of demyelinating lesions in the cervical spine. METHODS: The MRI studies of 33 patients with MS (42 lesions) and 55 patients with CSM (60 lesions) were obtained...
August 23, 2018: Clinical Neuroradiology
Yangting Cai, Haixiong Lin, Feng Huang, Xiaohui Zheng, Yaohua Huang, Shuncong Zhang
RATIONALE: Multiple diaphyseal sclerosis (MDS), known as Ribbing disease, is a rare congenital bone disease resulting from autosomal recessive inheritance. The case study involved a 22-year-old female patient who had been diagnosed with chronic sclerosing osteomyelitis due to lack of knowledge about MDS. Previous studies reported rarely on this condition. PATIENT CONCERNS: A 22-year-old female with MDS was analyzed. DIAGNOSES: MDS is characterized radiographically by a fusiform widening of the diaphyseal portion of the long bones, which is caused by a thickening of the cortex with obstruction of the medullary cavity...
August 2018: Medicine (Baltimore)
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...
October 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...
September 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
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