Study Shows Patients Commonly Misdiagnosed with Multiple Sclerosis

A new study found that approximately 18% of patients were misdiagnosed with multiple sclerosis (MS) before being referred to 2 major Los Angeles medical centers for treatment.

Many of the symptoms of MS can mimic other conditions, such as stroke, migraines, and vitamin B12 deficiency, which can make it difficult to accurately diagnose the condition. Often, providers must rule out other potential diagnoses first.

The study, which was published in Multiple Sclerosis and Related Disorders, examined the incidence of MS misdiagnosis referred to 2 academic MS referral centers, common alternate diagnoses, and factors associated with misdiagnosis. The researchers, led by Marwa Kaisey, MD, and Nancy Sicotte, MD, interim chair of Neurology and director of the Cedars-Sinai Multiple Sclerosis and Neuroimmunology Center, analyzed 241 patients who had been diagnosed by other physicians and referred to Cedars-Sinai Medical Center or the University of California, Los Angeles (UCLA) MS clinics over the course of 1 year.

Overall, 17% of Cedars-Sinai patients and 19% of UCLA patients were identified as having been misdiagnosed with the condition. The study showed that the most common correct diagnoses were migraine (16%), radiologically isolated syndrome (9%), spondylopathy (7%), and neuropathy (7%). Additionally, the researchers determined that clinical syndromes and radiographic findings atypical of MS were both associated with misdiagnosis.

Overall, approximately 1 in 5 patients who carried an established diagnosis of MS did not fulfill contemporary McDonald Criteria and had a more likely alternative diagnosis, the study showed.

Consequently, 72% of misdiagnosed patients were prescribed MS therapies and 48% of these patients received drug therapies that carry a known risk of developing progressive multifocal leukoencephalopathy. Patients who were misdiagnosed with MS spent an average of 4 years receiving treatments before being correctly diagnosed, according to the researchers.

Misdiagnoses can negatively impact patient morbidity and health care costs, leading to unnecessary financial burden for patients. The researchers estimated that unneeded MS treatments in the study alone cost approximately $10 million.

“I’ve seen patients suffering side effects from the medication they were taking for a disease they didn’t have,” Dr Kaisey said in a press release about the study findings. “Meanwhile, they weren’t getting treatment for what they did have. The cost to the patient is huge—medically, psychologically, financially.”

The study authors concluded that further research into new biomarkers and improved imaging techniques can help improve the diagnostic process and prevent future MS misdiagnoses.

References

Study of Multiple Sclerosis Patients Shows 18 Percent Misdiagnosed [news release]. Cedars-Sinai Medical Center. https://www.cedars-sinai.org/newsroom/study-of-multiple-sclerosis-patients-shows-18-percent-misdiagnosed/. Accessed April 8, 2019.

Kaisey M, Solomon A, Luu M, et al. Incidence of multiple sclerosis misdiagnosis in referrals to two academic centers. Multiple Sclerosis and Related Disorders. 2019. https://doi.org/10.1016/j.msard.2019.01.048