"Undiagnosing" multiple sclerosis: the challenge of misdiagnosis in MS

Neurology. 2012 Jun 12;78(24):1986-91. doi: 10.1212/WNL.0b013e318259e1b2. Epub 2012 May 11.


Objective: To describe the clinical characteristics of encounters with patients misdiagnosed with multiple sclerosis (MS).

Methods: A cross-sectional Internet-based physician survey of MS specialists was performed.

Results: The response rate for the survey was 50.4%. Of those who responded, the majority (95%) reported having evaluated 1 or more patients who had been diagnosed with MS, but who they strongly felt did not have MS, within the last year. The majority of respondents (>90%) also reported the use of disease-modifying therapy in a proportion of these patients. Most respondents (94%) found clinical encounters with these patients equally or more challenging than giving a new diagnosis of MS. Fourteen percent of respondents reported that they did not always inform such patients of their opinion that they did not have MS.

Conclusions: The misdiagnosis of MS is common and has significant consequences for patient care and health care system costs. Caring for a patient with a misdiagnosis of MS is challenging, and at times honest disclosure of a misdiagnosis represents an important ethical concern for neurologists. More data are needed on this patient population to improve diagnostic acumen and the care of these patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cross-Sectional Studies
  • Diagnostic Errors / economics*
  • Health Care Costs*
  • Health Care Surveys
  • Humans
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / economics
  • Neurology / economics