{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T06:58:08Z","timestamp":1764831488032,"version":"3.46.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>The diagnosis of multiple sclerosis (MS) is based on the McDonald diagnostic criteria and the exclusion of relevant differential diagnoses. This study aimed to determine the relative frequencies of MS differential diagnoses and to identify which diagnostic measures are most effective in distinguishing those from one another.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of all cases treated in the neurology ward of the University Hospital Regensburg during the years 2019 and 2020. The inclusion criteria comprised cases presenting with subacute focal neurological symptoms accompanied by corresponding lesions on magnetic resonance imaging (MRI) that could not be primarily attributed to MS, tumor, hemorrhage, or ischemia, as well as cases with abnormal external MRI findings who were referred to our clinic for the evaluation or exclusion of multiple sclerosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 127 cases were included in the study. Differential diagnoses of MS were predominantly of inflammatory or vascular origins or non-specific white matter lesions. The primary diagnostic tools for distinguishing differential diagnoses of MS from one another were patient history (fever), cerebrospinal fluid analysis, and brain MRI, as well as a duplex ultrasound of the cranial vessels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our study demonstrates that cerebrospinal fluid analysis and brain MRI are essential not only for the diagnosis of MS but also for distinguishing among its various differential diagnoses. In particular, duplex ultrasound may assist in identifying vascular lesions, while the presence of fever may suggest an infectious cause.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1695071","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T05:16:54Z","timestamp":1764825414000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential diagnoses of MS in clinical practice: incidence and methods for differential diagnosis"],"prefix":"10.3389","volume":"16","author":[{"given":"Tim Johannes","family":"Steinberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucie","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Freudenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klemens","family":"Angstwurm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf A.","family":"Linker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De-Hyung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1016\/S1474-4422(25)00270-4","article-title":"Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria","volume":"24","author":"Montalban","year":"2025","journal-title":"Lancet 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Open"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"4656","DOI":"10.3390\/jcm12144656","article-title":"Absence of Oligoclonal bands in multiple sclerosis: a call for differential diagnosis","volume":"12","author":"Katsarogiannis","year":"2023","journal-title":"J Clin Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s00415-025-12947-y","article-title":"Multiple sclerosis diagnosis and its differential diagnosis in patients presenting with type four \u2018mirror pattern\u2019 CSF oligoclonal bands","volume":"272","author":"Marastoni","year":"2025","journal-title":"J Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.1007\/s00415-023-12047-9","article-title":"Increasing age of multiple sclerosis onset from 1920 to 2022: a population-based study","volume":"271","author":"Habbestad","year":"2024","journal-title":"J Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"17562864241284166","DOI":"10.1177\/17562864241284166","article-title":"The impact of different lifestyle factors on disability in multiple sclerosis at older ages: a monocentric retrospective study","volume":"17","author":"Wecker","year":"2024","journal-title":"Ther Adv Neurol Disord"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/17474930221144911","article-title":"Cerebral small vessel disease: recent advances and future directions","volume":"18","author":"Markus","year":"2023","journal-title":"Int J Stroke"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e2527","DOI":"10.1212\/WNL.0000000000007573","article-title":"\u201cBetter explanations\u201d in multiple sclerosis diagnostic workup: a 3-year longitudinal study","volume":"92","author":"Calabrese","year":"2019","journal-title":"Neurology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1001\/archneur.61.9.1366","article-title":"Migraine is associated with magnetic resonance imaging white matter abnormalities: a meta-analysis","volume":"61","author":"Swartz","year":"2004","journal-title":"Arch Neurol"},{"key":"ref13","year":""},{"key":"ref14","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1007\/s11055-025-01815-x","article-title":"Difficulties in the in-life diagnosis of Creutzfeldt\u2013Jakob disease","volume":"55","author":"Kicherova","year":"2025","journal-title":"Neurosci Behav Physiol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1695071\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T05:16:54Z","timestamp":1764825414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1695071\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,4]]},"references-count":14,"alternative-id":["10.3389\/fneur.2025.1695071"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1695071","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,4]]},"article-number":"1695071"}}