{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T13:19:52Z","timestamp":1794057592544,"version":"4.8.0"},"reference-count":9,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Seronegative neuromyelitis optica spectrum disorder (NMOSD) is a diagnostic challenge. This study aimed to characterize misapplication of the 2015 international criteria for seronegative NMOSD. We reviewed 35 consecutive seronegative NMOSD referrals to a tertiary center. Two (6%) met formal criteria, and 2 (6%) were clinically suspected of NMOSD without fulfilling radiologic supportive criteria. Alternative diagnoses were common including multiple sclerosis (37%), optic neuritis (14%), functional neurologic disorder (11%), and other (38%). Immunosuppression with rituximab was used in 3 of 4 patients with functional neurologic disorder. Misapplication of the 2015 criteria is common, and alternative explanations in seronegative NMOSD patients should be strongly considered.<\/jats:p>","DOI":"10.1177\/13524585251360648","type":"journal-article","created":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T09:40:32Z","timestamp":1755337232000},"page":"1381-1384","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Unveiling Misdiagnosis: Rethinking Seronegative NMOSD"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0895-0903","authenticated-orcid":false,"given":"Mary V.","family":"Lang","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant M.","family":"Welk","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8419-8728","authenticated-orcid":false,"given":"Deena A.","family":"Tajfirouz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA"},{"name":"Department of Ophthalmology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin D.","family":"Chodnicki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean J.","family":"Pittock","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA"},{"name":"Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine and Science, 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