Editors' Note

Abstract

Editors' Note: Regarding “The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study,” Dalla Costa et al. express concerns about the interpretation of results because of the number of patients screened, the clinical and paraclinical characteristics of the misdiagnosed patients, and the lack of specification of fulfilled multiple sclerosis (MS) criteria through which the diagnosis was made. Solomon et al., authors of the study, explain that the study was not designed to assess the frequency of MS misdiagnosis or its specific causes. They add that application of MS diagnostic criteria to a neurologic syndrome not typical for MS contributed to misdiagnosis in 65% of cases, and that in 60% of cases, using MRI criteria for dissemination in space in a patient with nonspecific symptoms contributed to misdiagnosis. Commenting on “Early start of DOAC after ischemic stroke: Risk of intracranial hemorrhage and recurrent events,” Prof. Kawada argues that larger patient cohorts more accurately estimate the risk of intracranial hemorrhage (ICH) from direct, non–vitamin K antagonist oral anticoagulants (DOACs). Seiffge et al., authors of the study, agree but point out that they looked at symptomatic ICH only and a well-designed randomized clinical trial is necessary to address timing of DOAC after ischemic stroke due to nonvalvular atrial fibrillation. —Chafic Karam, MD, and Robert C. Griggs, MD Editors' Note: Regarding “The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study,” Dalla Costa et al. express concerns about the interpretation of results because of the number of patients screened, the clinical and paraclinical characteristics of the misdiagnosed patients, and the lack of specification of fulfilled multiple sclerosis (MS) criteria through which the diagnosis was made. Solomon et al., authors of the study, explain that the study was not designed to assess the frequency of MS misdiagnosis or its specific causes.