What gets confused with MS?

For many patients, the road to a diagnosis of multiple sclerosis (MS) is a bumpy one. Symptoms can be so varied, vague, and hard to describe, often another condition will be suspected before MS. Sometimes, people live with an incorrect diagnosis before they get the correct one.

Here are some of the conditions that are commonly confused with MS.

Fibromyalgia

Fibromyalgia is a chronic condition where people experience widespread pain, fatigue, sleep disturbances, and cognitive difficulties, often referred to as ‘fibro fog.’ Like MS, fibromyalgia can cause significant fatigue and cognitive issues. However, fibromyalgia does not cause the same kind of neurological damage as MS.

Unlike MS, fibromyalgia doesn’t typically show up on MRI scans. The pain in fibromyalgia is often more widespread and is not accompanied by the nerve damage that is seen in MS. Additionally, while MS often has a relapsing-remitting course, fibromyalgia tends to be more consistent in its symptoms, although they may vary in intensity.

Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is another condition that shares similarities with MS, particularly the overwhelming fatigue that can be debilitating. People with CFS experience profound exhaustion that doesn’t improve with rest and may worsen after physical or mental exertion, a phenomenon known as post-exertional malaise.

MS can also cause significant fatigue, making it difficult to differentiate between the two. However, CFS doesn’t cause the same neurological symptoms, such as vision problems or motor difficulties, which are more characteristic of MS. Additionally, the cause of CFS remains unknown, and it is typically diagnosed by ruling out other conditions, including MS.

Lyme Disease

Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through tick bites. Early symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans which has a bullseye-like pattern. If left untreated, Lyme disease can spread to the joints, heart, and nervous system, leading to neurological symptoms that can mimic those of MS, such as numbness, weakness, and cognitive issues. One distinguishing factor is the presence of the rash in early Lyme disease, which does not occur in MS. It doesn’t occur in every case of Lyme disease, however. Blood tests can also identify antibodies to the bacteria that cause Lyme disease, which can help differentiate it from MS. However, in some cases, the tests may be inconclusive, adding to the confusion.

Lupus

Lupus, or systemic lupus erythematosus (SLE), is another autoimmune disease that can be mistaken for MS. Lupus can affect various parts of the body, including the skin, joints, kidneys, and nervous system. Neurological symptoms of lupus, such as headaches, confusion, and memory loss, can overlap with those of MS. Lupus can also cause inflammation of the brain and spinal cord, similar to the lesions seen in MS. However, lupus is more likely to affect other organs, such as the kidneys, and is often accompanied by a variety of other symptoms, such as a butterfly-shaped rash across the cheeks and nose, sensitivity to sunlight, and joint pain. Blood tests can detect specific antibodies associated with lupus, helping to differentiate it from MS.

Stroke

A stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting enough oxygen and nutrients. This can cause sudden symptoms, such as weakness or numbness on one side of the body, trouble speaking or understanding speech, and vision problems. These symptoms can sometimes be mistaken for an MS flare-up, particularly if the person has no previous history of MS. The sudden onset of symptoms is a key distinguishing factor, as MS symptoms usually develop more gradually. Brain imaging, such as an MRI or CT scan, can also help differentiate between a stroke and MS by revealing the cause of the symptoms.

If you suspect someone may be having a stoke, always call 999 and ask for an ambulance.

Neuromyelitis optica

Neuromyelitis optica (NMO), also known as Devic’s disease, is a rare condition that can be easily confused with MS because it also involves inflammation of the optic nerve and spinal cord. However, NMO is distinct from MS in several ways. NMO often causes more severe attacks, and these attacks are more likely to lead to permanent damage. The symptoms of NMO tend to be more focused on the optic nerves and spinal cord, causing severe vision loss and paralysis. Blood tests can help differentiate between NMO and MS, as NMO is associated with specific antibodies, such as anti-aquaporin-4 (AQP4) antibodies, which are not present in MS.

Migraines

Migraines are severe headaches that can cause a variety of neurological symptoms, including visual disturbances, nausea, and sensitivity to light and sound. Some people with migraines also experience numbness or tingling, which can be confused with MS. However, migraine symptoms are usually transient and related to the headache phase, while MS symptoms are more persistent and progressive. Additionally, migraines do not cause the same type of brain lesions that are seen in MS on MRI scans.

As you can see, there are plenty of things MS can be confused with. Similar symptoms are the cause of misdiagnosis which can add to the length of being properly diagnosed. Our dedicated information booklet on the symptoms of MS is a good follow up to this which we’ve linked below if you’d like to learn more.