Selected aspects of diagnosis of multiple sclerosis Review article
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Abstract
There are few diseases in which the diagnosis is as important as in multiple sclerosis: this diagnosis determines the management of the patient for years to come, often for the rest of his/her life. Therefore, the diagnostic process of people with suspected demyelinating disease should be carried out carefully and not succumb to the uncritical pressure of quick diagnosis when there are doubts. Unfortunately, almost every practicing neurologist has encountered cases of misdiagnosis, sometimes with serious consequences. Based on the available literature, this article lists diseases most commonly confused with multiple sclerosis and describes common mistakes in the approach to the diagnosis of demyelinating disease, including examples of often ignored „red flags”. Selected practical issues related to the use of McDonald’s diagnostic criteria, correct interpretation of additional tests and the interview with patient were also discussed. Meticulous and critical documentation of the patient’s relapses, a sober approach to the results of supplementary tests, and in some cases a willingness to adopt a wait-and-see attitude will help reduce the number of errors and contribute to a more rational use of drug program resources.
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