Contributions
Abstract: EP1339
Type: ePoster
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Background: Many neurological diseases can mimic multiple sclerosis (MS). However, it remains unclear which alternative diagnoses are typically seen at a quaternary care MS clinic, especially in the contemporary era, which includes clinical advances such as routine use of MRI. We set out to examine these alternative diagnoses in individuals referred to the University of British Columbia (UBC) MS clinic in Vancouver, Canada.
Methods: This was a retrospective chart review of individuals who visited the UBC MS clinic between 2007-2013, and were determined at any point as "not-MS" by an MS specialist neurologist. Potentially eligible individuals were identified through the British Columbia MS clinic database. A standardized data capture form was used for chart abstraction, which included: sex, age, medical history, initial and most recent diagnosis. "Not-MS" individuals were grouped as: "confirmed not-MS" (with an alternative diagnoses recorded), "converted to MS" (later diagnosed as MS), and "other CNS inflammatory conditions" (e.g., clinically isolated syndrome, recurrent transverse myelitis, optic neuritis, neuromyelitis optica).
Results: From the database, 212 individuals labeled as "not MS" during the study period were identified. The mean age at referral was 42 years (SD=13; range 16-78); 159 (75%) were women.
Of these, 100 were "confirmed not-MS", 22 "converted to MS", and 90 had other CNS inflammatory conditions. In the "confirmed not-MS" group, the alternative diagnoses at the most recent assessment were: benign sensory symptoms (n=24), migraine (n=12), pain syndrome (n=12), non-specific white matter changes (n=8), autoimmune/inflammatory conditions (n=8), neuromuscular (n=6), psychiatric (n=5), vascular (n=4), infectious (n=3), neurodegenerative (n=3), peripheral vertigo (n=2), cervical spondylosis (n=2), ataxia (n=2), post-concussion (n=2), non-specific visual symptoms (n=2), and other (n=5).
Conclusions: In individuals referred to a quaternary care MS clinic and determined not to have MS at the most recent assessment, the most frequently observed alternative diagnosis was "benign sensory symptoms" affecting 24%, followed by migraine (12%), and pain syndrome (12%).
Disclosure:
Alice Schabas: nothing to disclose.
Helen Tremlett is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis. She currently receives research support from the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation. In addition, in the last five years she has received research support from the Multiple Sclerosis Society of Canada (Don Paty Career Development Award); the Michael Smith Foundation for Health Research (Scholar Award) and the UK MS Trust; speaker honoraria and/or travel expenses to attend conferences from the Consortium of MS Centres (2013), the National MS Society (2012, 2014, 2016), Teva Pharmaceuticals (2011), ECTRIMS (2011, 2012, 2013, 2014, 2015, 2016), UK MS Trust (2011), the Chesapeake Health Education Program, US Veterans Affairs (2012), Novartis Canada (2012), Biogen Idec (2014), American Academy of Neurology (2013, 2014, 2015, 2016). All speaker honoraria are either declined or donated to an MS charity or to an unrestricted grant for use by her research group.
Anthony Traboulsee has received personal compensation for activities with Genzyme and Roche. Dr. Traboulsee has received research support from Genzyme, Roche, Chugai.
Ana-Luiza Sayao: nothing to disclose.
Abstract: EP1339
Type: ePoster
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Background: Many neurological diseases can mimic multiple sclerosis (MS). However, it remains unclear which alternative diagnoses are typically seen at a quaternary care MS clinic, especially in the contemporary era, which includes clinical advances such as routine use of MRI. We set out to examine these alternative diagnoses in individuals referred to the University of British Columbia (UBC) MS clinic in Vancouver, Canada.
Methods: This was a retrospective chart review of individuals who visited the UBC MS clinic between 2007-2013, and were determined at any point as "not-MS" by an MS specialist neurologist. Potentially eligible individuals were identified through the British Columbia MS clinic database. A standardized data capture form was used for chart abstraction, which included: sex, age, medical history, initial and most recent diagnosis. "Not-MS" individuals were grouped as: "confirmed not-MS" (with an alternative diagnoses recorded), "converted to MS" (later diagnosed as MS), and "other CNS inflammatory conditions" (e.g., clinically isolated syndrome, recurrent transverse myelitis, optic neuritis, neuromyelitis optica).
Results: From the database, 212 individuals labeled as "not MS" during the study period were identified. The mean age at referral was 42 years (SD=13; range 16-78); 159 (75%) were women.
Of these, 100 were "confirmed not-MS", 22 "converted to MS", and 90 had other CNS inflammatory conditions. In the "confirmed not-MS" group, the alternative diagnoses at the most recent assessment were: benign sensory symptoms (n=24), migraine (n=12), pain syndrome (n=12), non-specific white matter changes (n=8), autoimmune/inflammatory conditions (n=8), neuromuscular (n=6), psychiatric (n=5), vascular (n=4), infectious (n=3), neurodegenerative (n=3), peripheral vertigo (n=2), cervical spondylosis (n=2), ataxia (n=2), post-concussion (n=2), non-specific visual symptoms (n=2), and other (n=5).
Conclusions: In individuals referred to a quaternary care MS clinic and determined not to have MS at the most recent assessment, the most frequently observed alternative diagnosis was "benign sensory symptoms" affecting 24%, followed by migraine (12%), and pain syndrome (12%).
Disclosure:
Alice Schabas: nothing to disclose.
Helen Tremlett is the Canada Research Chair for Neuroepidemiology and Multiple Sclerosis. She currently receives research support from the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation. In addition, in the last five years she has received research support from the Multiple Sclerosis Society of Canada (Don Paty Career Development Award); the Michael Smith Foundation for Health Research (Scholar Award) and the UK MS Trust; speaker honoraria and/or travel expenses to attend conferences from the Consortium of MS Centres (2013), the National MS Society (2012, 2014, 2016), Teva Pharmaceuticals (2011), ECTRIMS (2011, 2012, 2013, 2014, 2015, 2016), UK MS Trust (2011), the Chesapeake Health Education Program, US Veterans Affairs (2012), Novartis Canada (2012), Biogen Idec (2014), American Academy of Neurology (2013, 2014, 2015, 2016). All speaker honoraria are either declined or donated to an MS charity or to an unrestricted grant for use by her research group.
Anthony Traboulsee has received personal compensation for activities with Genzyme and Roche. Dr. Traboulsee has received research support from Genzyme, Roche, Chugai.
Ana-Luiza Sayao: nothing to disclose.