Identifying Atypical Forms, Presentations of Demyelinating Disease: Oliver Tobin, MBBCh, BAO, PhD


The associate professor of neurology at Mayo Clinic Rochester discusses the importance of alternative diagnoses and rarer presentations of MS, in order to avoid misdiagnoses and inappropriate treatment for patients.

“Several studies from various centers have shown that almost 20% of patients who have a diagnosis of multiple sclerosis who attend a subspecialty clinic are found to be misdiagnosed, so that’s pretty concerning.”

In multiple sclerosis (MS), misdiagnosis has proven to be a challenge, with a variety of other demyelinating disorders and mimics to differentiate from. The need to improve this has become a topic of much focus at MS societal meetings in recent years, and some estimates place the misdiagnosis rate in MS at roughly 20%.

Oliver Tobin, MBBCh, BAO, PhD, associate professor of neurology, Mayo Clinic Rochester, recently discussed differential diagnoses and atypical presentations of MS at the recent Institutional Perspectives in Neurology: Multiple Sclerosis With Brian Weinshenker, MD, held earlier this month. In conversation with NeurologyLive about his presentation at the virtual event, Tobin commented on the importance of understanding the clinical presentations of these pathologies, which are often nonspecific and inflammatory, in an effort to decrease misdiagnoses.

Tobin further discussed common mimics and atypical presentations that can arise, highlighting the need to identify “red flags” that may point to other conditions such as bilateral optic neuritis, bilateral simultaneous optic neuritis, severe optic neuritis, longitudinally extensive optic neuritis, longitudinally extensive myelitis, and persistent enhancement for more than 3 months. With studies showing almost 1 in 5 patients with MS may have been misdiagnosed, the need to be aware of alternative diagnoses becomes that much more vital. 

For more coverage of the Institutional Perspectives in Neurology: Multiple Sclerosis With Brian Weinshenker, MD, click here.

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