Pattern Recognition of the Multiple Sclerosis Syndrome
1
Department of Neurological Sciences, University of Nebraska Medical Center College of Medicine, Omaha, NE 68198-8440, USA
2
University of Nebraska Medical Center College of Nursing, Omaha, NE 68198-5330, USA
*
Author to whom correspondence should be addressed.
Brain Sci. 2017, 7(10), 138; https://doi.org/10.3390/brainsci7100138
Received: 29 August 2017 / Revised: 29 September 2017 / Accepted: 17 October 2017 / Published: 24 October 2017
(This article belongs to the Special Issue Pathophysiology and Imaging Diagnosis of Demyelinating Disorders)
During recent decades, the autoimmune disease neuromyelitis optica spectrum disorder (NMOSD), once broadly classified under the umbrella of multiple sclerosis (MS), has been extended to include autoimmune inflammatory conditions of the central nervous system (CNS), which are now diagnosable with serum serological tests. These antibody-mediated inflammatory diseases of the CNS share a clinical presentation to MS. A number of practical learning points emerge in this review, which is geared toward the pattern recognition of optic neuritis, transverse myelitis, brainstem/cerebellar and hemispheric tumefactive demyelinating lesion (TDL)-associated MS, aquaporin-4-antibody and myelin oligodendrocyte glycoprotein (MOG)-antibody NMOSD, overlap syndrome, and some yet-to-be-defined/classified demyelinating disease, all unspecifically labeled under MS syndrome. The goal of this review is to increase clinicians’ awareness of the clinical nuances of the autoimmune conditions for MS and NMSOD, and to highlight highly suggestive patterns of clinical, paraclinical or imaging presentations in order to improve differentiation. With overlay in clinical manifestations between MS and NMOSD, magnetic resonance imaging (MRI) of the brain, orbits and spinal cord, serology, and most importantly, high index of suspicion based on pattern recognition, will help lead to the final diagnosis.
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Keywords:
MS; NMOSD; clinically isolated syndrome (CIS); optic neuritis; transverse myelitis; brainstem syndrome; tumefactive demyelinating lesions; AQP4 antibodies; MOG antibodies
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MDPI and ACS Style
Zabad, R.K.; Stewart, R.; Healey, K.M. Pattern Recognition of the Multiple Sclerosis Syndrome. Brain Sci. 2017, 7, 138.
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