How can I suspect misdiagnosis of multiple sclerosis (MS)?

There are a few red flags to be aware of. They do not necessarily signal a misdiagnosis, but they suggest a need for medical reevaluation.

Although some cases with onset before age ten or after age fifty have been reported, this is so rare that a multiple sclerosis (MS) diagnosis is suspect. This is also true for onset prior to age forty of the rarer type of MS, which is without remission. Called "primary-progressive" MS, this is usually seen in patients with onset after age forty.

When the lesion is at the junction of the skull and cervical spine it can often appear as if there are two separate lesions, with the brain stem and spinal cord both affected. This can actually be a single lesion such as a tumor. Here the magnetic resonance imaging (MRI) is crucial in the diagnosis.

Hemianoptic field defects, in which half of the visual field (right or left) is impaired in both eyes, are so rare in MS that it is prudent to investigate other causes.

Geographical background that is inconsistent with the well-defined pattern of the world's MS population should make an MS diagnosis questionable. For example, if a patient grew up in the tropics or in a part of Asia where MS is extremely rare, other diseases, such as those caused by parasites, must be considered before MS.

Pain as a predominant symptom renders a diagnosis of MS suspect. Pain can be a symptom of MS. In fact, it is seen in up to 30 percent of patients at some point in the course of the disease. However, there are only a few kinds of pain associated with MS; others should be considered suspicious.

A so-called family history of MS should be cause for caution. Since there is such a low incidence of MS in families, there is a possibility that the entire family has been misdiagnosed and may actually suffer from another neurological disorder - a heredo-degenerative disease.