Defining and diagnosing multiple sclerosis can be difficult, for both physicians and patients, which is why a rigorous battery of tests is required to get a definitive answer. There are a number of other ailments that easily mimic at least some of the more common symptoms of this neurodegenerative disease, making it easy to mistake one for the other. Finding a diagnosis is often crucial to treating not only MS but other diseases and conditions that could be detrimental to your health that appear to be similar.
1. Vitamin B12 deficiency
It’s reasonable that a deficiency of vitamin B12 leads to similar symptoms as multiple sclerosis, since both involve damage to the myelin sheath that protects the nerves, which then causes a breakdown in communication between the brain and other nerves. Both conditions result in weakness, reduced mobility, and cognitive issues. However, B12 deficiency more commonly appears in older individuals, and symptoms often disappear with B12 supplements.
2. Lyme disease
Lyme disease is contracted from a tick bite rather than an autoimmune reaction. It might be mistaken for MS due to lesions on the brain. However, a spinal tap can determine the difference between the two, and treatment with hefty antibiotics will typically relieve symptoms that are similar to multiple sclerosis.
This STI (sexually transmitted infection) appears very similar to MS because of the organs it infects. Patients experience cognitive issues, speech issues, difficulty walking, and strange sensations similar to pins and needles, like patients with MS. However, a quick blood test looking for antibodies against syphilis can make a clear determination between the two.
Because migraines are often a symptom of multiple sclerosis, occurring at a much higher rate than in the general public, there have been many patients misdiagnosed with MS who only suffer from migraines. It’s difficult to tell the difference between the two without performing the same rigorous diagnostic tools used to rule out anything other than MS as the culprit of symptoms. In a study of MS and possible misdiagnosis, of those who were wrongly diagnosed with multiple sclerosis, about twenty-two percent actually only suffered migraines, making it the largest misdiagnosis in the study.
5. Conversion and psychogenic disorders
People suffering from these disorders typically translate emotional and mental issues, including stress, into physical pain of some kind. Symptoms are often similar to MS, such as general pain, difficulty with mobility, blindness, and weakness. However, multiple sclerosis presents with very tangible damage to the central nervous system, whereas the average patient with a conversion or psychogenic disorder doesn’t have a physical ailment that explains the symptoms. Based on a study, about eleven percent of patients diagnosed with MS actually had one of these disorders rather than MS.
Fibromyalgia can look very much like multiple sclerosis, with headache, musculoskeletal pain, fatigue, numbness and tingling in the limbs, and a much higher rate of diagnosis in women than men. However, an MRI won’t produce any notable results in fibromyalgia patients, whereas it will show lesions in the brain for MS patients.
7. Neuromyelitis optica and ADEM
In NMO, which was once considered a form of MS, the attack on myelin is contained to the spinal cord and optic nerve in the beginning stages. While almost all symptoms are identical to MS, cognitive functions are retained, while symptoms like vomiting and hiccups accompany NMO. The disease is also treated very differently. In ADEM (acute disseminated encephalomyelitis), symptoms have a more rapid onset than in MS, due to a severe attack of inflammation in the brain and spinal cord. However, ADEM occurs more often in children and likely comes on after an infection, whether viral or bacterial.
Multiple sclerosis and lupus are similar in several ways. They are both autoimmune diseases and both far more common in women than men. Both are chronic with no cure, and their symptoms include muscle pain, fatigue, and headache. Like MS, lupus has no definitive diagnostic tool, so it takes several lab tests and a comparison of the number of symptoms suffered to make the determination.
A stroke is caused when insufficient blood flow reaches the brain, meaning adequate oxygen and nutrients are not provided. When this happens, brain cells start to die rapidly, and some symptoms that could be mistaken as MS appear, including numbness in the limbs, difficulty walking, slurred speech, and vision impairment. A patient’s knowledge of their typical flare up can help separate the two, as well as age, since the majority of stroke victims are over the age of fifty-five. However, any question should result in a call to emergency services and medical attention.
10. Sjögren’s syndrome
An autoimmune disease that starts by attacking the salivary and tear glands, Sjögren’s Syndrome can also spread to other parts of the body, resulting in symptoms such as fatigue and musculoskeletal pain, mimicking multiple sclerosis. However, the telltale signs of Sjögren’s Syndrome, despite being more common in women like MS, are dry mouth and dry eyes.
Because the many types of vasculitis involve inflammation of the blood vessels in various areas of the body, patients may mistake weakness, numbness and tingling limbs, joint pain, and blurred vision for multiple sclerosis. However, most of the time, the disease is localized to a particular area of the body, the symptoms will be as well, negating the question of MS.
Another autoimmune disease that causes inflammation and its complications, patients could experience this in the central nervous system, causing fatigue or vision problems. However, sarcoidosis separates itself from MS by typically starting with attacks on the lungs and lymph nodes and possibly affecting the skin, none of which is typical for multiple sclerosis.
13. Myasthenia gravis
The occurrence of myasthenia gravis is very similar to multiple sclerosis. An autoimmune reaction produces antibodies that attack, instead of the CNS, the communication network between the peripheral nerves and the muscles. While the area affected is different, the symptoms of fatigue, weakness, and muscle pain mimic multiple sclerosis.
14. Parkinson’s disease
Parkinson’s disease and multiple sclerosis both affect the brain and the rest of the central nervous system, which means that some of the symptoms could be the same, ranging from cognitive issues like memory loss to weakness in the limbs and slurred speech. However, the mechanisms that cause these symptoms are different, with Parkinson’s occurring due to the death of tissue in the brain.
ALS attacks the brain and spinal cord, just like MS, and both diseases cause issues with mobility, as well as causing damage such as scarring to the nerves. However, ALS is not an autoimmune disease, and rather than attacking the myelin coating over the nerves, it destroys the nerves themselves.
In many ways, multiple sclerosis and Guillain-Barré syndrome are effectively the same. They are both autoimmune, chronic, neurodegenerative diseases, with the list of symptoms almost identical. However, an MRI can distinguish the difference between the two because MS attacks the central nervous system, while GBS attacks the peripheral nervous system.
17. Transverse myelitis
In transverse myelitis, there is a section of the spinal cord where inflammation has damaged the nerves, which then affects that section and any of the spinal cord below it. This leads to very similar symptoms as MS, but most of the time, damage is contained to a small area and is mild. In addition, MS is chronic, whereas transverse myelitis usually only occurs once and does not return.
Diagnosing multiple sclerosis is a tough process, but it’s also necessary because there are so many other diseases that masquerade as MS. In addition, if the patient does have one of these other ailments, it’s important to identify this and treat it accordingly.