好色先生

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Abstract Details

Challenges in Multiple Sclerosis Diagnosis: Misapplication and Misunderstanding of the McDonald Criteria
Multiple Sclerosis
S6 - MS and CNS Inflammatory Disease: Clinical Considerations I (1:00 PM-1:11 PM)
001

Studies suggest knowledge gaps for identification of typical MS syndromes, periventricular and juxtacortical MRI lesion locations, and consideration of historical symptoms may cause MS misdiagnosis.
To assess proper application of McDonald Criteria key elements among neurology residents and multiple sclerosis (MS) specialists.

Neurology residents and practicing MS specialists completed a web-based survey by email invitation.
72 residents and 88 MS specialists from the US and Canada participated. MS atypical syndromes that were incorrectly identified as typical included: complete transverse myelopathy (35% residents, 15% MS specialists), intractable vomiting/nausea/hiccups (20% residents, 5% MS specialists), and bilateral optic neuritis/unilateral optic neuritis with poor visual recovery (17% residents, 10% MS specialists). “Touch or abutting” the ventricle criterion for periventricular lesions was correctly identified by 38% of residents and 61% of MS specialists; “juxtacortical” criterion was correctly identified by 19% of residents and 54% of MS specialists. Optic nerve involvement was incorrectly identified as a region for fulfillment of MRI dissemination in space (DIS) by 31% of residents and 26% of MS specialists. Subcortical white matter was incorrectly identified by 11% of residents and 18% of MS specialists as a region for fulfillment of MRI DIS. A Radiologically Isolated Syndrome (RIS) case was incorrectly assigned fulfillment of McDonald Criteria by 48% of residents and 12% of MS specialists. Non-specific historical visual symptoms were considered fulfillment of dissemination in time (DIT) by 75% of residents and 49% of MS specialists, and non-specific historical sensory and coordination symptoms were considered fulfillment of DIT by 88% of residents and 65% MS specialists. Additional case-based and imaging-based responses will be presented.
Neurology residents and, to a lesser degree, MS specialists incorrectly identified core components of the MS diagnostic criteria. 好色先生al efforts could potentially reduce misdiagnosis by concentrating on misunderstood and misapplied components of the McDonald Criteria.
Authors/Disclosures
Andrew Solomon, MD, FAAN
PRESENTER 		Dr. Solomon has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Solomon has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech/Roche . Dr. Solomon has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kiniksa Pharmaceuticals . Dr. Solomon has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Solomon has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. The institution of Dr. Solomon has received research support from Bristol Meyers Squibb.
No disclosure on file
Robert T. Naismith, MD, FAAN (Washington University) Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squib. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Naismith has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Genzyme. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celltrion. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impaact-Bio. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyverna. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch.
Salim Chahin, MD (Washington University School of Medicine, Neurology Dept.) Dr. Chahin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Chahin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Chahin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutic . The institution of Dr. Chahin has received research support from National MS Society. The institution of Dr. Chahin has received research support from BMS.
Stephen Krieger, MD, FAAN (Mount Sinai Dept of Neurology) Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Krieger has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Krieger has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Expert Witness. The institution of Dr. Krieger has received research support from Novartis. The institution of Dr. Krieger has received research support from Bristol Myers Squibb. The institution of Dr. Krieger has received research support from Biogen.
Brian G. Weinshenker, MD, FAAN (University of Virginia Health System) Dr. Weinshenker has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CANbridge Pharmaceuticals. Dr. Weinshenker has received personal compensation in the range of $0-$499 for serving as a Consultant for CALIBR. Dr. Weinshenker has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Weinshenker has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Weinshenker has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Group (Chugai, Genentech, Roche). Dr. Weinshenker has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharmaceuticals. Dr. Weinshenker has received research support from Guthy Jackson Charitable Foundation. Dr. Weinshenker has received intellectual property interests from a discovery or technology relating to health care.