Diagnostic guidelines for multiple sclerosis (MS) should be amended to first rule out the presence of neuromyelitis optica spectrum disorder (NMOSD), a neurological inflammatory disease that also affects the brain and spinal cord, a study recommends.
The study, “Can a Diagnosis of Multiple Sclerosis Be Made Without Ruling Out Neuromyelitis Optica Spectrum Disorder?,” was published in the journal Multiple Sclerosis and Related Disorders.
MS is a neurodegenerative disorder whose symptoms may be very similar to those of other neurological diseases, including NMOSD. For that reason, and because at this point there is no single test one can take to determine the presence of the disease, getting an accurate diagnosis of MS can be challenging.
Over the years, diagnostic criteria have been established in an attempt to solve this problem. To assess if patients meet the predefined criteria and rule out other disorders that mimic MS, physicians may request patients undergo a series of tests, including magnetic resonance imaging (MRI) scans and spinal fluid analysis.
Nowadays, screening tests for NMOSD, including tests to detect the presence of aquaporin 4 (AQP4), are recommended but not mandatory to establish a diagnosis of MS.
Jagannadha Avasarala, MD, PhD, a neurologist at the Kentucky Neuroscience Institute (KNI) and colleagues now have carried out a study they believe demonstrates that tests should be mandatory to rule out NMOSD before a definitive diagnosis of MS can be made.
In the study, they analyzed data from 319,994 patients who had been diagnosed with MS and had at least one year of uninterrupted health insurance coverage. Patient data was extracted from the Truven Health Analytics (THA) database.
From the 319,994 patients who originally were diagnosed with MS, 2,001 (0.62%) were later diagnosed with NMOSD.
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