The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study.

Autor:	Solomon AJ; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN. andrew.solomon@uvm.edu., Bourdette DN; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Cross AH; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Applebee A; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Skidd PM; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Howard DB; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Spain RI; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Cameron MH; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Kim E; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Mass MK; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Yadav V; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Whitham RH; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Longbrake EE; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Naismith RT; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Wu GF; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Parks BJ; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Wingerchuk DM; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Rabin BL; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Toledano M; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Tobin WO; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Kantarci OH; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Carter JL; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Keegan BM; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN., Weinshenker BG; From the Departments of Neurological Sciences (A.J.S., A.A.) and Ophthalmology (P.M.S.), and Center for Clinical and Translational Science (D.B.H.), University of Vermont, Burlington; Department of Neurology (D.N.B., R.I.S., M.H.C., E.K., M.K.M., V.Y., R.H.W.), Oregon Health & Science University, Portland; Department of Neurology (A.H.C., E.E.L., R.T.N., G.F.W., B.J.P.), Washington University, St. Louis, MO; Department of Neurology (D.M.W., B.L.R., J.L.C.), Mayo Clinic, Scottsdale, AZ; and Department of Neurology (M.T., W.O.T., O.H.K., B.M.K., B.G.W.), Mayo Clinic, Rochester, MN.
Jazyk:	angličtina
Zdroj:	Neurology [Neurology] 2016 Sep 27; Vol. 87 (13), pp. 1393-9. Date of Electronic Publication: 2016 Aug 31.
DOI:	10.1212/WNL.0000000000003152
Abstrakt:	Objective: To characterize patients misdiagnosed with multiple sclerosis (MS). Methods: Neurologists at 4 academic MS centers submitted data on patients determined to have been misdiagnosed with MS. Results: Of 110 misdiagnosed patients, 51 (46%) were classified as "definite" and 59 (54%) "probable" misdiagnoses according to study definitions. Alternate diagnoses included migraine alone or in combination with other diagnoses 24 (22%), fibromyalgia 16 (15%), nonspecific or nonlocalizing neurologic symptoms with abnormal MRI 13 (12%), conversion or psychogenic disorders 12 (11%), and neuromyelitis optica spectrum disorder 7 (6%). Duration of misdiagnosis was 10 years or longer in 36 (33%) and an earlier opportunity to make a correct diagnosis was identified for 79 patients (72%). Seventy-seven (70%) received disease-modifying therapy and 34 (31%) experienced unnecessary morbidity because of misdiagnosis. Four (4%) participated in a research study of an MS therapy. Leading factors contributing to misdiagnosis were consideration of symptoms atypical for demyelinating disease, lack of corroborative objective evidence of a CNS lesion as satisfying criteria for MS attacks, and overreliance on MRI abnormalities in patients with nonspecific neurologic symptoms. Conclusions: Misdiagnosis of MS leads to unnecessary and potentially harmful risks to patients. Misinterpretation and misapplication of MS clinical and radiographic diagnostic criteria are important contemporary contributors to misdiagnosis. (© 2016 American Academy of Neurology.)
Databáze:	MEDLINE
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