Misdiagnosis of multiple sclerosis

http://www.ncbi.nlm.nih.gov/pubmed/22581930

Neurology. 2012 May 11. [Epub ahead of print]

"Undiagnosing" multiple sclerosis: The challenge of misdiagnosis in MS.

Solomon AJ, Klein EP, Bourdette D.

Source

From the Department of Neurology (A.J.S.), Fletcher Allen Heath Care, University Health Center, University of Vermont College of Medicine, Burlington; Department of Neurology (F.P.K., D.B.), Oregon Health & Science University, Portland; and Neurology Service (F.P.K., D.B.) and MS Center of Excellence-West (D.B.), Department of Veterans Affairs Medical Center, Portland, OR.

Abstract

OBJECTIVE:

To describe the clinical characteristics of encounters with patients misdiagnosed with multiple sclerosis (MS).

METHODS:

A cross-sectional Internet-based physician survey of MS specialists was performed.

RESULTS:

The response rate for the survey was 50.4%. Of those who responded, the majority (95%) reported having evaluated 1 or more patients who had been diagnosed with MS, but who they strongly felt did not have MS, within the last year. The majority of respondents (>90%) also reported the use of disease-modifying therapy in a proportion of these patients. Most respondents (94%) found clinical encounters with these patients equally or more challenging than giving a new diagnosis of MS. Fourteen percent of respondents reported that they did not always inform such patients of their opinion that they did not have MS.

CONCLUSIONS:

The misdiagnosis of MS is common and has significant consequences for patient care and health care system costs. Caring for a patient with a misdiagnosis of MS is challenging, and at times honest disclosure of a misdiagnosis represents an important ethical concern for neurologists. More data are needed on this patient population to improve diagnostic acumen and the care of these patients.