{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:45:48Z","timestamp":1790423148423,"version":"4.1.0"},"reference-count":71,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>(1) Background: The emergence of white matter lesions in the central nervous system (CNS) can lead to diagnostic dilemmas. They are a common radiological symptom and their patterns may overlap CNS or systemic diseases and provoke underdiagnosis or misdiagnosis. The aim of the study was to assess factors influencing the underdiagnosis of neuromyelitis optica spectrum disorder (NMOSD) as well as to estimate NMOSD epidemiology in Lubelskie voivodeship, Poland. (2) Methods: This retrospective study included 1112 patients, who were made a tentative or an established diagnosis of acute or subacute onset of neurological deficits. The evaluation was based on medical history, neurological examination, laboratory and radiographic results and fulfilment of diagnosis criteria. (3) Results: Up to 1.62 percent of patients diagnosed with white matter lesions and up to 2.2% of the patients previously diagnosed with MS may suffer from NMOSD. The duration of delayed diagnosis is longer for males, despite the earlier age of onset. Seropositive cases for antibodies against aquaporin-4 have worse prognosis for degree of disability. (4) Conclusions: Underdiagnosis or misdiagnosis in NMOSD still remains a problem in clinical practice and has important implications for patients. The incorrect diagnosis is caused by atypical presentation or NMOSD-mimics; however, covariates such as gender, onset and diagnosis age may also have an influence.<\/jats:p>","DOI":"10.3390\/brainsci12070885","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T09:41:10Z","timestamp":1657100470000},"page":"885","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["NMOSD\u2014Diagnostic Dilemmas Leading towards Final Diagnosis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7384-283X","authenticated-orcid":false,"given":"Anna K.","family":"Szewczyk","sequence":"first","affiliation":[{"name":"Doctoral School, Medical University of Lublin, ul. Chod\u017aki 7, 20-093 Lublin, Poland"},{"name":"Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Papu\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystyna","family":"Mitosek-Szewczyk","sequence":"additional","affiliation":[{"name":"Department of Child Neurology, Medical University of Lublin, ul. Profesora Antoniego Gebali 6, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Wo\u015b","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Statistics with E-Learning Lab, ul. Jaczewskiego 4, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7019-6681","authenticated-orcid":false,"given":"Konrad","family":"Rejdak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E964","DOI":"10.1212\/WNL.0000000000006116","article-title":"White matter lesions spatial heterogeneity, links to risk factors, cognition, genetics, and atrophy","volume":"91","author":"Habes","year":"2018","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101452","DOI":"10.1016\/j.msard.2019.101452","article-title":"Differential diagnosis of multiple sclerosis and other inflammatory CNS diseases","volume":"37","author":"Wildner","year":"2020","journal-title":"Mult. Scler. Relat. 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