Differential diagnoses of multiple sclerosis

• May 6, 2024

Cerebrospinal fluid (CSF) test

By examining the cerebrospinal fluid of those who have been diagnosed with multiple sclerosis (EM ), the electrophoretic patterns can be observed. These are composed of bands that indicate a significant increase in the gamma globulin of the person. In fact, approximately 85% of patients with MS present this finding.

In general, the glucose level is within the normal range. However, that of proteins can be slightly increased and the proliferation of white blood cells ranges from lightly to moderately increased, specifically in mononuclear cells.

Myelin basic protein is an important differential diagnosis in MS. This component of myelin increases. However, doctors do not recommend using it as a marker to indicate the process or progression of multiple sclerosis.

Blood tests

People with MS should undergo B12 tests and folate levels, including their antinuclear antibodies (ANA). These tests are essential as long as there is evidence of a rapid deterioration in the degeneration of your spinal cord.

Several patients with MS who experience optic neuritis and extensive spinal cord injuries should undergo optical neuromyelitis. This test will determine the presence of antibodies to aquaporins 4.

A globular sedimentation rate is also necessary, in addition to the rheumatoid factor. These specific blood tests help to identify if the illness that the person suffers is MS or simply a vasculitic disease.

The image studios

MRI of the head or spine, with or without gadolinium, should be performed depending on the suspicion of the location of the lesions.

Those that appear in relation to multiple sclerosis usually appear to be T2 hyperintensities that are found within the periventricular areas. These typical lesions have an ovoid shape and generally affect only the white matter. In some cases, several lesions grow in the corpus callosum of the brain.

Each time the scans indicate injuries of the corpus callosum, it is called as Dawson. This term comes from the work done by James Dawson in 1916 as a neuropathological test of the University of Edinburgh. This type of condition indicates that cells associated with inflammation have been distributed in the veins and venules of brain tissues.

Imaging studies can also show plaque formation, especially in infraterritorial regions. On the other hand, these areas are affected more frequently by plaques in the peduncles of the cerebellum, the surface of the bridge and also the part closest to the white matter of the fourth ventricle.

Once gadolinium is used as a contrast medium, some lesions become luminescent. This result is indicative of an active disease process. This means that the blood-brain barrier has been broken due to a constant process of subacute inflammation, which ranges from a few days to several weeks. If this luminosity is observed, it is a symptom of a demyelinating process.

Video Medicine: Differential diagnosis for Multiple Sclerosis (May 2024).