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Symptoms and Signs – Differential Diagnosis of Multiple Sclerosis (MS)
• Autoimmune: acute disseminated encephalomyelitis (ADEM), postvaccination encephalomyelitis
• Degenerative: subacute combined degeneration (vitamin B12 deficiency), inherited spastic paraparesis
• Infections: progressive multifocal leukoencephalopathy, Lyme disease, syphilis, HIV infection, human T-cell lymphotropic virus type 1 (HTLV-1), Whipple’s syndrome, expanded differential in immunocompromised patients
• Inflammatory: systemic lupus erythematosus (SLE), Sjögren’s syndrome, Behçet’s syndrome, vasculitis, sarcoidosis, celiac disease
• Inherited metabolic disorders: leukodystrophies
• Mitochondrial: Leber’s hereditary optic neuropathy; mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS)
• MS variants: recurrent optic neuropathy, neuromyelitis optica (Devic’s), acute tumor-like lesion (Marburg’s variant), Baló’s concentric sclerosis, myelinoclastic diffuse sclerosis (Schilder’s disease)
• Neoplasms: metastases, CNS lymphoma
• Vascular: subcortical infarcts, Binswanger’s disease
• Autoimmune: acute disseminated encephalomyelitis (ADEM), postvaccination encephalomyelitis
• Degenerative: subacute combined degeneration (vitamin B12 deficiency), inherited spastic paraparesis
• Infections: progressive multifocal leukoencephalopathy, Lyme disease, syphilis, HIV infection, human T-cell lymphotropic virus type 1 (HTLV-1), Whipple’s syndrome, expanded differential in immunocompromised patients
• Inflammatory: systemic lupus erythematosus (SLE), Sjögren’s syndrome, Behçet’s syndrome, vasculitis, sarcoidosis, celiac disease
• Inherited metabolic disorders: leukodystrophies
• Mitochondrial: Leber’s hereditary optic neuropathy; mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS)
• MS variants: recurrent optic neuropathy, neuromyelitis optica (Devic’s), acute tumor-like lesion (Marburg’s variant), Baló’s concentric sclerosis, myelinoclastic diffuse sclerosis (Schilder’s disease)
• Neoplasms: metastases, CNS lymphoma
• Vascular: subcortical infarcts, Binswanger’s disease
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