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Prof Sten Fredrikson: Diagnostic and differential diagnosis aspects in MS
Prof Fredrikson speaks about the importance of differential diagnosis in MS patients, stating that even in well-established MS clinics there is a 5-10% rate of misdiagnosis.
The three key aspects of diagnosis in MS are clinical history, neurological examination result, and laboratory results including MRI examination of the brain and cerebrospinal fluid analysis. In particular, important advances have been made in MRI, resulting in new diagnostic criteria; although interpretation of MRI results still needs improvement.
Prof Fredrikson stresses the importance of combining MRI results with clinical history, neurological findings and CSF results. In particular, CSF analysis is very useful in primary progressive MS and in older patients. There are as many as 100 possible differential diagnoses, such as metabolic disease, infectious disease and vascular disease, but overall these are very rare in MS patients.
Prof Fredrikson concludes that the clinical neurologist plays the pivotal role in giving a correct MS diagnosis.
The interview was recorded at the annual ECTRIMS meeting from 14-17 September 2016 in London, United Kingdom.
Sten Fredrikson, Professor of Neurology, Karolinska University Hospital Huddinge, Stockholm, Sweden.