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Challenges in multiple sclerosis diagnosis: Misunderstanding and misapplication of the McDonald criteria
- Source :
- Multiple sclerosis (Houndmills, Basingstoke, England). 27(2)
- Publication Year :
- 2020
-
Abstract
- Objective: To assess comprehension and application of the McDonald criteria. Background: Studies suggest that knowledge gaps for specific core elements of the McDonald criteria may contribute to multiple sclerosis (MS) misdiagnosis. Methods: Neurology residents (NR) and multiple sclerosis specialists (MSS) in North America completed a web-based survey. Results: A total of 160 participants were included: 72 NR and 88 MSS. Syndromes incorrectly identified as typical of MS included: complete transverse myelopathy (35% NR and 15% MSS), intractable vomiting/nausea/hiccoughs (20% NR and 5% MSS), and bilateral optic neuritis/unilateral optic neuritis with poor visual recovery (17% NR and 10% MSS). Periventricular magnetic resonance imaging (MRI) lesions were correctly identified by 39% NR and 52% MSS, and juxtacortical lesions were correctly identified by 28% NR and 53% MSS. The correct definition of “periventricular” was chosen by 38% NR and 61% MSS, and that of “juxtacortical” was chosen by 19% NR and 54% MSS. Regions incorrectly identified for MRI dissemination in space fulfillment included the optic nerve (31% NR and 26% MSS) and the subcortical white matter (11% NR and 18% MSS). The majority of participants assessed previous non-specific neurological symptoms without objective evidence of a central nervous system (CNS) lesion as sufficient for clinical dissemination in time. Conclusion: The McDonald criteria are often misunderstood and misapplied. Concerted educational efforts may prevent MS misdiagnosis.
- Subjects :
- Multiple Sclerosis
Optic Neuritis
Multiple sclerosis
McDonald criteria
Optic Nerve
medicine.disease
Magnetic Resonance Imaging
Comprehension
03 medical and health sciences
0302 clinical medicine
Neurology
medicine
Humans
030212 general & internal medicine
Neurology (clinical)
Diagnostic Errors
Psychology
030217 neurology & neurosurgery
Cognitive psychology
Subjects
Details
- ISSN :
- 14770970
- Volume :
- 27
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Multiple sclerosis (Houndmills, Basingstoke, England)
- Accession number :
- edsair.doi.dedup.....0a5b0f6434b01a898541ea4528fa9721