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The most common imitators of multiple sclerosis (MS) are other autoimmune diseases and infections; however, an increasing number of metabolic diseases have been recognized as uncommon mimics of MS (table). While MRI has revolutionized the diagnosis of MS, it has also led to occasional overinterpretation of white matter disease as MS. In this issue of Neurology®, Keegan et al.1 describe a series of patients referred for possible MS who were eventually diagnosed with a rare condition: leukoencephalopathy with neuroaxonal spheroids. Their report suggests that degenerative axonal diseases may be more common than we realize. Also, it reminds us that not all MRI white matter spots are due to MS.
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Table Primary differential diagnosis of multiple sclerosis
The five patients described by Keegan et al.1 were all referred to the Mayo Clinic for evaluation of possible MS. However, atypical features prompted a more …
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