Diseases Less Likely to Be Misdiagnosed as MS
While these diseases may have some symptoms that are similar to those of MS, they also have enough characteristics that are different from MS that misdiagnosing one for the other should happen only rarely.
10. Lyme Disease
Lyme disease is a bacterial infection transmitted by tick bites. Early symptoms include fatigue, fever, headaches, and muscle and joint aches. Later symptoms can include numbness and tingling in the hands and feet, as well as cognitive problems, such as short-term memory loss and speech issues. If you live in an area that’s known to have Lyme disease in it, or if you have recently traveled to one, your doctor will want to rule out the possibility.
11. Neuropathy
Both MS and neuropathy involve nerve damage, but whereas MS impacts the central nervous system (CNS), neuropathy usually refers to peripheral neuropathy, or damage to the nervous system outside the brain and spinal cord (which make up the CNS). Peripheral nerves connect the brain and spinal cord to the rest of the body.
Peripheral neuropathy is particularly common in people with diabetes, because high blood glucose levels damage the peripheral nerves.
People with neuropathy may experience loss of coordination, muscle weakness, or difficulty walking or moving their arms or legs, similar to people with MS. However, there are several kinds of neuropathy — sensory, motor, and autonomic — each with its own set of symptoms, and it’s usually fairly easy for a neurologist to distinguish between those two, says Conway. “Although they can produce similar symptoms, the clinical picture is usually a lot different,” he says.
12. Lupus
Lupus is a chronic autoimmune disorder that, like MS, affects more women than men. It can cause muscle pain, joint swelling, fatigue, and headaches. The hallmark symptom of lupus is a butterfly-shaped rash covering the cheeks and bridge of the nose that shows up in about half of people who are diagnosed. There is no single diagnostic test for lupus, and because its symptoms are similar to those of many other conditions, it is sometimes called “the great imitator.”
Rheumatologists (physicians specializing in diseases of the muscles and joints) typically diagnose lupus based on a number of laboratory tests and the number of symptoms characteristic of lupus that a person has.
“Although lupus can affect the nervous system, it’s rare. The changes that we would see in an MRI are usually a little different than what we would see with MS,” says Conway.
13. Stroke
A stroke occurs when a portion of the brain stops receiving a steady supply of blood and consequently doesn’t get the oxygen and nutrients it needs in order to survive. Symptoms of a stroke generally evolve rapidly and include loss of vision; loss of feeling in the limbs, usually on one side of the body; difficulty walking; and difficulty speaking. All of these signs can also occur as part of an MS flare, or exacerbation, but there’s a crucial difference.
“The presentation of stroke tends to be very different, because it’s very acute in its onset, and MS is usually a slower process,” says Conway.
The age of the person experiencing the symptoms can also help to pin down the correct diagnosis. While MS can occur at any age, the likelihood of having a stroke goes up with age, while the likelihood of developing MS goes down.
A stroke requires immediate attention; if you think you’re experiencing a stroke, call 911.
14. Sjögren’s Syndrome
With the autoimmune disorder Sjögren’s syndrome, the immune system mistakenly attacks the glands that produce tears and saliva, which in turn causes the hallmark symptoms of dry eyes and mouth.
The condition does share symptoms with MS, including fatigue and musculoskeletal pain, and, like MS, it is more common in women than in men.
However, this misdiagnosis is unlikely because Sjögren’s is a fairly rare condition, and it would only be a subset of patients whose Sjögren’s symptoms would mimic MS, says Conway.
15. Myasthenia Gravis
Myasthenia gravis is a chronic autoimmune disease that causes muscle weakness that typically comes and goes but tends to progress over time. A defect in the transmission of nerve impulses to the muscles is what causes the weakness.
In many people, the first signs of myasthenia gravis are drooping eyelids and double vision. Like MS, it can also cause difficulty with walking, speaking, chewing, and swallowing. If a doctor suspects that you have myasthenia gravis, a number of tests can help to confirm or rule out the diagnosis.
How a person responds to certain medicines can also aid in the diagnosis. If an anticholinesterase medicine dramatically improves muscle weakness for a brief period, it confirms a diagnosis of myasthenia gravis.
“Myasthenia gravis is a disease of the peripheral nervous system,” says Conway. “It’s fairly rare that this condition would be mistaken for MS, [because] patients who have it would present differently in a physical exam.”
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