Multiple sclerosis and Moyamoya angiopathy: Mimic and misdiagnosis.

Mult Scler Relat Disord

Department of Neurology, Institute of Post Graduate Medical Education & Research, Bangur Institute of Neurosciences, Kolkata, India. Electronic address:

Published: October 2022

AI Article Synopsis

  • - Moyamoya Angiopathy (MMA) is often overlooked when diagnosing Multiple Sclerosis (MS), leading to misdiagnoses, as highlighted in this first prospective study.
  • - Out of 160 confirmed MMA cases, 5 (3.13%) were initially misdiagnosed as MS, predominantly affecting females (80%), with most presenting symptoms like hemiparesis and having identifiable triggers.
  • - Key radiological features aiding differentiation included the presence of "Ivy" sign and abnormal flow voids, with careful examination of white matter lesions being crucial to accurately distinguish MMA from MS.

Article Abstract

Moyamoya Angiopathy (MMA) is frequently not considered in differential diagnosis of Multiple Sclerosis (MS). This is the first study to prospectively analyze rate of misdiagnosis of MMA as MS and its clinical implications. Of the 160 angiographically proven MMA, 5 patients had an initial misdiagnosis of MS (3.13%). These 5 cases had female-predominance (80%).Out of the 5 cases, 4 cases (80%) presented with hemiparesis; 3 cases (60%) had an immediate precipitating factor. Radiologically, presence of both periventricular and juxtacortical white-matter-lesions was seen in 4 out of 5 cases (80%);none had infratentorial/spinal lesion, while all 5 cases had presence of "Ivy" sign and abnormal flow voids. Differentiation relies on careful evaluation of clinico-radiological features. MMA should be considered as a rare but important differential to MS.

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Source
http://dx.doi.org/10.1016/j.msard.2022.104036DOI Listing

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