Conditions like MS

There are many conditions that are similar to MS (Multiple Sclerosis).  They may be caused by demyelination.  Sometimes these conditions become MS if there are other attacks over time.  Here are some examples:

Transverse Myelitis

This condition causes a feeling of numbness or weakness affecting the legs and sometimes the body.  It may feel like a level or band of numbness around the waist or the chest.

This is a condition in which a section of the spinal cord becomes demyelinated.  There are less aggressive and more aggressive types of this condition.  Less aggressive types affect less than 3 spinal segments, cause minor symptoms, and recover well, sometimes without treatment.  More aggressive types may cause weakness or difficulty breathing, and they tend to affect more than 3 spinal segments.  Transverse myelitis is associated with viral illnesses, inflammatory illnesses (such as systemic lupus erythematosis or MS), although not all causes of this condition are known.  This condition may be treated with intravenous steroids or plasma exchange.  About 10-20% of patients with this condition develop MS later on.

Optic Neuritis

Optic neuritis, or ON, is a condition that is sometimes inherited.  Inflammation of the optic nerve results in pale, blurry, or absent vision, normally in one eye, and it may be painful.  This condition normally improves with steroid treatment.  About 30-40% of patients with optic neuritis develop MS within 10 years.

Neuromyelitis Optica

NMO is a condition when both the optic nerves and the spinal cord are affected by inflammation, causing weakness and blindness.   The two kinds of symptoms usually occur within weeks of each other.  Treatment is normally intravenous steroids or plasma exchange, although advanced therapies have been attempted.   This condition is associated with antibodies to a protein called Aquaporin 4.  These antibodies may be found in the blood or CSF of patients with this illness.

Systemic Lupus Erythematosis

SLE is a condition that may affect the skin, muscles, joints, kidneys or brain.  There are 12 recognized features of this disorder.  Fever and joint pain occur in about 90% of people with this disoder.  Demyelinating lesions of the brain are rare but may occur in SLE.  These can be difficult to distinguish from lesions caused by MS.  Patients with SLE often have abnormal blood tests, including a positive ANA titer and dsDNA antibodies.

Neurosarcoid

This is an inflammatory condition that may affect the brain, the skin, and the lungs.  It is a different kind of inflammation that than seen in MS, and it is treated with different medicines.  It may affect cranial nerves, peripheral nerves, or the eyes as well.

Marburg variant

This is an aggressive form of MS that may affect the deeper structures of the brain.  It is usually progressive and it may be resistant to treatment.  Over weeks this may result in the need for critical care.   Unlike other forms of MS, the progression of the lesion(s) may be evident over a short time frame, such as weeks, and signs such as prolonged loss of awareness or alertness may be present.

 

CADASIL

CADASIL means “cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy”.  It often has a history of strokes at a young age, migraine, and possibly, vascular dementia.  It is tested for by genetic testing or by skin biopsy.  It is associated with a NOTCH3 mutation.  MRI studies of people with CADASIL may show confluent T2 lesions in the periventricular white matter and temporal lobes.

Acute Disseminated Encephalomyelitis (ADEM)

This is an inflammatory condition that causes rapid loss of function and large white matter lesions in the brain.  CSF testing for oligocloncal bands is often negative.  Many patients with this severe illness recover completely.  Relapses may occur, but they are not very common.

Susac Syndrome

This is a rare condition of hearing loss, visual loss and encephalopathy.  As in MS, this condition may show T2 abnormalities and T1 holes in the corpus callosum- findings that are common in MS.  Symptoms may last a long time but recovery has been reported.