Which conditions are included in the differential diagnoses of pediatric multiple sclerosis (MS)?

Updated: Jan 30, 2019
  • Author: Alice K Rutatangwa, DO, MSc; Chief Editor: Amy Kao, MD  more...
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Answer

Differentials

Other disorders that can mimic MS include the following:

  • Endocrine: Thyroid disorder, diabetes mellitus

  • Inflammatory: Systemic lupus erythematosus (SLE), neurosarcoidosis, Sjögren syndrome, antiphospholipid antibody syndrome (APLAS), Behçet disease, isolated angiitis

  • Mitochondrial: Myoclonic epilepsy with ragged red fibers (MERRF), mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS), Leber hereditary optic neuropathy (LHON), Leigh syndrome, Kearns-Sayre syndrome

  • Leukodystrophy: Metachromatic leukodystrophy, adrenoleukodystrophy, Krabbe disease, Pelizaeus-Merzbacher disease, Refsum disease, vanishing white matter, leukoencephalopathy with brainstem and spinal cord involvement and elevated lactate levels, Wilson disease, Fabry disease, Alexander disease

  • Genetic/metabolic: Inborn errors of metabolism, aminoacidurias

  • Infectious: Neuroborreliosis (lyme disease), HSV encephalitis, HIV infection, neurocysticercosis, poststreptococcal infection, abscess, neurosyphilis, progressive multifocal leukoencephalopathy (PML), Whipple disease

  • Vascular: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), Moyamoya disease, carotid dissection

  • Demyelinating: Clinically isolated syndrome, ADEM, optic neuritis, transverse myelitis, NMO, postvaccination, acute necrotizing encephalopathy

  • Nutritional: Vitamin B12, vitamin E, or folate deficiency; celiac disease

  • Neoplastic: Lymphoma, astrocytoma, medulloblastoma, metastases

  • Toxic: Radiation, chemotherapy (methotrexate, cyclosporine, cytosine-arabinoside), extrapontine myelinosis

  • Other: Langerhans cell histiocytosis, hemophagocytic lymphohistiocytosis


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