Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden.
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Mult Scler Relat Disord. 2021 Jul;52:102977. doi: 10.1016/j.msard.2021.102977. Epub 2021 Apr 24.
Differential diagnosis of multiple sclerosis (MS) includes a variety of disorders and misdiagnosis is common.
To follow-up persons with suspected onset of MS but in whom the diagnostic investigation was negative.
In a prospective study including 271 persons with clinical features of suspected MS onset, 136 persons were diagnosed with MS or clinically isolated syndrome (PwMS), 46 had other disorders, and 89 persons had a negative diagnostic work-up, i.e. persons with undetermined diagnosis (PwUD). They underwent diagnostic reassessment, and those who remained without a diagnosis were investigated for signs of pathology including cognitive tests and assessments of quality of life (QoL). Results were compared with those of PwMS and 24 age and sex matched healthy controls (HC).
After reassement 55 (20%) persons still had undetermined diagnosis (PwUD). They had similar age and gender distribution as PwMS. In 76% of PwUD, the suspected clinical onset included sensory symptoms. PwUD and PwMS scored similarly in cognitive tests and QoL but significantly lower than HC. At 3 years follow-up, PwMS and PwUD improved in most test parameters, but PwUD scored lower than PwMS in cognition.
PwUD constituted the dominating differential diagnosis in persons with suspected clinical onset of MS. QoL and cognition were comparable with those of PwMS but significantly lower than in HC.
多发性硬化症（MS）的鉴别诊断包括多种疾病，误诊较为常见。
对疑似 MS 发病但诊断性检查为阴性的患者进行随访。
在一项包括 271 名具有疑似 MS 发病临床特征的患者的前瞻性研究中，136 名患者被诊断为 MS 或临床孤立综合征（PwMS），46 名患有其他疾病，89 名患者诊断性检查结果为阴性，即诊断不明患者（PwUD）。对他们进行了重新诊断评估，对那些仍未明确诊断的患者进行了病理检查，包括认知测试和生活质量（QoL）评估。结果与 PwMS 和 24 名年龄和性别匹配的健康对照（HC）进行了比较。
重新评估后，仍有 55 名（20%）患者的诊断仍不明确（PwUD）。他们的年龄和性别分布与 PwMS 相似。在 76%的 PwUD 中，疑似临床发病包括感觉症状。PwUD 和 PwMS 在认知测试和 QoL 方面的评分相似，但明显低于 HC。在 3 年随访中，PwMS 和 PwUD 在大多数测试参数方面都有所改善，但 PwUD 在认知方面的评分仍低于 PwMS。
PwUD 是疑似 MS 临床发病患者的主要鉴别诊断。QoL 和认知与 PwMS 相似，但明显低于 HC。
