Different diagnoses of patients referred to multiple sclerosis outpatient clinic

Abstract

The aim of this study is to investigate the frequency and type of MS mimics in the patients who were diagnosed with MS in other centers and applied to our MS center in the last 3 years. We included all patients who applied to our MS clinic between January 1, 2016 and December 31, 2018 for the first time in our retrospective study. The definitive diagnosis was recorded and demographic, clinical, laboratory, electrophysiological and radiological variables were collected. 296 patients were included in the study. Of 235 patients referred from other centers, 166 (70.6%) confirmed the diagnosis of definitive MS, while 69 (29.4%) had an alternative diagnosis. While 52.5% of the patients referred with clinical suspicion were diagnosed with MS, 8.1% of those who were referred with radiological suspicion were diagnosed with MS. The most frequently diagnosed diagnoses were: non-specific MRI white matter lesions (17.9%), migraine (11.5%), psychogenic (8.9%), systemic autoimmune diseases (6.4%), NMO (4, 7%), and genetic diseases (1,7%). Factors that assisted in the correct diagnosis were; non-specific MRI findings, normal neurological examination, normal evoked potentials, isolated MRI findings, MRI findings not fulfilling 2010 McDonald criteria, absence of oligoclonal bands, cognitive presenting symptoms, family story. Our study shows that 29,4% of patients had an alternative diagnosis. The most common mimickers of MS in our center is not different from what has been described in other countries. Neurological signs and symptoms, age, family story, DNA analysis, laboratory and radiological findings can help with the true diagnosis.