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Multiple Sclerosis Lecture Series: Diagnosis

Learning Objectives
1. Apply a 4-step approach to confirming a Multiple Sclerosis diagnosis
2. Summarize barriers to making a correct Multiple Sclerosis diagnosis
3. Recognize the consequences of making a Multiple Sclerosis misdiagnosis
0.75 Credit CME

Internet Enduring Material sponsored by Stanford University School of Medicine. Presented by the Stanford University School of Medicine's Department of Neurology and Center for Continuing Medical Education. How is Multiple Sclerosis accurately diagnosed? This second lecture in the Multiple Sclerosis Series explores how to use a 4-step process to confirm if a patient has MS. Listen and examine 2 case studies and learn common barriers to a correct diagnosis. Learn why there are consequences to misdiagnosing MS in patients. This activity will appeal to all healthcare providers who want expert instruction about the diagnostic criteria, best practices in examination, careful interpretation of MRI scans, and common mistakes to avoid.

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Video Information

All Rights Reserved. The content of this activity is protected by U.S. and International copyright laws. Reproduction and distribution of its content without written permission of its creator(s) is prohibited.

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation Statement: Stanford Medicine designates this Enduring Material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This educational activity is supported in part by an educational grant from Novartis Pharmaceuticals Corporation.

Financial Support Disclosure Statement: Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

Disclosure of faculty and their commercial relationships will be made prior to the activity.

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity.

Lucas B. Kipp, MD

Stanford Hospital & Clinics

Course Director

Grant or research support-Roche/Genentech

Grant or research support-Biogen Idec

Jamie McDonald, MD

Stanford Health Care

Reviewer

Nothing to disclose

Ruth Adewuya, MD, CHCP

Managing Director, CME

Stanford University School of Medicine

Planner

Nothing to disclose

Marilyn Mejia, BA

Education Design Coordinator

Stanford University

Planner

Nothing to disclose

References:
1.
 Acting on Incidental Findings in Research Imaging  |  The BMJ. Accessed May 10, 2022. https://www.bmj.com/content/351/bmj.h5190.Google Scholar
2.
Aliaga  ES, Barkhof  F.  MRI Mimics of Multiple Sclerosis.  In: Goodwin  DS, eds.  Handbook of Clinical Neurology: Multiple Sclerosis and Related Disorders. Elsevier; 2014, Vol 122: 291–316.Google Scholar
3.
Brownlee  WJ, Hardy  TA, Fazekas  F, Miller  DH.  Diagnosis of multiple sclerosis: progress and challenges.  Lancet. 2017;389(10076):1336–1346. doi:10.1016/S0140-6736(16)30959-XGoogle Scholar
4.
Geraldes  R, Juryńczyk  M, dos Passos  Gon behalf of the MAGNIMS study group,  et al.  Distinct influence of different vascular risk factors on white matter brain lesions in multiple sclerosis.  Journal of Neurology, Neurosurgery & Psychiatry. 2020;91:388–391.Google Scholar
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Giovannoni  G, Butzkueven  H, Dhib-Jalbut  S,  et al.  Brain health: time matters in multiple sclerosis.  Mult Scler Relat Disord. 2016;9Suppl 1:S5–S48. doi:10.1016/j.msard.2016.07.003Google Scholar
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Kingwell  E, Leung  AL, Roger  E,  et al.  Factors associated with delay to medical recognition in two Canadian multiple sclerosis cohorts.  J Neurol Sci. 2010;292(1–2):57–62. doi:10.1016/j.jns.2010.02.007Google Scholar
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Miller  DH, , Weinshenker  BG, Filippi  M, Banwell  BL, Cohen  JA, Freedman  MS, Galetta  SL,  et al.  “Differential Diagnosis of Suspected Multiple Sclerosis: A Consensus Approach.”  Multiple Sclerosis Journal14, no. 9 (November 1, 2008): 1157–74. https://doi.org/10.1177/1352458508096878.Google Scholar
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Ojha  P.  Optic Neuritis.  17:57:32 UTC. https://www.slideshare.net/NeurologyKota/optic-neuritis-54229738.
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Phillips  J, Theodore  T, Murray  Jock,  et al.  Multiple Sclerosis and Related Disorders. Edited by Fox  RJ, Rae-Grant  AD, and Bethoux  F. Springer Publishing; 2018. doi:10.1891/9780826125941
10.
Simonsen  CS, Flemmen  HØ, Lauritzen  T, Berg-Hansen  P, Moen  SM, Celius  EG.  The diagnostic value of IgG index versus oligoclonal bands in cerebrospinal fluid of patients with multiple sclerosis.  Mult Scler J Exp Transl Clin. 2020;6(1):2055217319901291. Published 2020 Jan 22. doi:10.1177/2055217319901291Google Scholar
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Solomon  AJ.  Diagnosis, Differential Diagnosis, and Misdiagnosis of Multiple Sclerosis.  Continuum (Minneap Minn). 2019;25(3):611–635. doi:10.1212/CON.0000000000000728Google Scholar
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Solomon  AJ, Bourdette  DN, Cross  AH,  et al.  The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study.  Neurology. 2016;87(13):1393–1399. doi:10.1212/WNL.0000000000003152Google Scholar
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Solomon  AJ, Klein  EP, Bourdette  D.  "Undiagnosing" multiple sclerosis: the challenge of misdiagnosis in MS.  Neurology. 2012;78(24):1986–1991. doi:10.1212/WNL.0b013e318259e1b2Google Scholar
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Solomon  AJ, Weinshenker  BG.  Misdiagnosis of Multiple Sclerosis: Frequency, Causes, Effects, and Prevention.  Current Neurology and Neuroscience Reports. 2013;13(12):403. doi:10.1007/s11910-013-0403-yGoogle Scholar
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Thompson  AJ, Banwell  BL, Barkhof  F.  Diagnosis of Multiple Sclerosis: 2017 revisions of the McDonald criteria.  Lancet. 2018;17(2):162–173. doi: 10.1016/S1474-4422(17)30470-2Google Scholar
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Yamout  B, Alroughani  R, Al-Jumah  M,  et al.  Consensus guidelines for the diagnosis and treatment of multiple sclerosis.  Curr Med Res Opin. 2013;29(6):611–621. doi:10.1185/03007995.2013.787979Google Scholar

Accreditation
In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation
Stanford Medicine designates this Enduring Material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

     

Participation Statement: Upon completion of this activity, learners will receive a Participation Certificate.

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