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User:FortWorthMedicalStudent23/Multiple sclerosis

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Differential diagnosis

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Several diseases present similarly to multiple sclerosis. Medical professionals use a patient's specific presentation, history, and exam findings to make an individualized differential. Red flags are findings that suggest an alternate diagnosis, although they do not rule out multiple sclerosis. Red flags include a patient younger than 15 or older than 60, less than 24 hours of symptoms, involvement of multiple cranial nerves, involvement of organs outside of the nervous system, and atypical lab and exam findings.

In an emergency setting, it is important to rule out a stroke or bleeding in the brain. Intractable vomiting, severe optic neuritis, or bilateral optic neuritis raises suspicion for neuromyelitis optica spectrum disorder (NMOSD). Infectious diseases that may look similar to multiple sclerosis include HIV, Lyme disease, and Syphilis. Autoimmune diseases include Sarcoidosis, Lupus, Guillain-Barré syndrome, Acute Disseminated Encephalomyelitis, and Behçet's disease. Psychiatric conditions such as Anxiety or Conversion disorder may also present in a similar way. Other rare diseases include CNS lymphoma, congenital leukodystrophies, and anti-MOG-associated myelitis.


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