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April2011 Vol.48 Issue:        2        Table of Contents
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Is it Multiple Sclerosis or its Mimic (Vasculitis)?

Shereen Fathi1, Omar Moawya2, Maha Abou-Elew3, Heba Abou-Elew4, Hanan Hosny5

 

Departments of Neurology1, Radiology2, Audiology3, Clinical Pathology4, Cairo University;

 Neurophysiology5, Beni-Suef University; Egypt

 



ABSTRACT

Background: The confusion in reaching the strict diagnosis of Multiple Sclerosis (MS) is increasing steadily as diseases that mimic MS are many and floating specifically vasculitis. A precise diagnosis should be reached ultrarapidly as vasculitis needs rapid management by chemotherapy to withhold disease progression and deterioration. Objective: Is to attest new tools to ascertain the diagnosis of MS versus vasculitis for best management of each. Methods: Thirty-eight patients were included: Group1: 19 patients with definite MS who meet the criteria of Modified McDonald serving as control group and Group2: 19 patients who meet the same criteria but may have other explanation to be labeled (MS mimics) mainly vasculitis. All subjects went through meticulous clinical neurological examination; laboratory testing; neurophysiological assessment via visual evoked potential and electroretinography; auditory brainstem response assessment and neuroradiological study via magnetic resonance imaging with different modalities. Results: A high statistically significant difference of criteria suggestive of vasculitis over MS was seen through positive history of headache, venous thrombosis, clinical evidence of preserved abdominal reflexes and positive laboratory testing for: Antinuclear Antibody, Anti Neutrophil Cytoplasmic Antibody, Lupus Anticoagulant and Anticardiolipin antibodies. As well, visual evoked potential, electroretinography and magnetic resonance imaging results with different modalities could share in such differentiation with statistically significant difference pointing for vasculitis. Conclusion: No unique test can peculiarly hit the target and ensure the accurate diagnosis of MS versus its mimic (vasculitis); yet a blend of tests still should take place to solve such dilemma. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(2): 163-169]

 

Key Words: multiple sclerosis, mimics, vasculitis, angiitis, Brain MRI/MTI/DWI.

 

Correspondence to Shereen Fathi, Department of neurology, Cairo University. Tel.: +20113022610    Email: shereenfathi@gmail.com.





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