Cervical spinal degenerative disease in multiple sclerosis

Abstract

Cervical spinal degenerative disease (SDD) and multiple sclerosis (MS) share clinical features, and misdiagnosis may occur. While cervical radicular pain in people with MS (PwMS) [1] should prompt a search for a compressive cause, it may uncommonly be a presenting symptom of MS in the absence of radicular compression [2-4], mostly due to root entry zone lesions. Painless cervical nerve root compression may occur in PwMS [5], where it is possible that pain pathways have been disrupted. Myelopathic symptoms could result from spinal cord demyelination or compressive canal stenosis; in particular, lower cervical or thoracic disc protrusions are easily missed [6] in people with progressive MS because a gradually worsening spastic paraparesis with bladder disturbance is one of the main clinical features in progressive MS and the cord may not be routinely imaged during follow-up. Multilevel disc herniations and compressive

MRI Markers of Degenerative Disc Disease in Young Patients With Multiple Sclerosis

“…5 Concurrently, recent evidence suggests that cervical spine degenerative changes are more common in MS patients. [6][7][8] While many factors have been implicated in cervical DDD, including disc dehydration due to natural aging and chronic flexion of the neck with increasing use of electronic devices, 9 the role of MS in this disease process is not well understood.…”

Real‐world challenges in the diagnosis of primary progressive multiple sclerosis

“…Cervical spinal stenosis was the most common confounding comorbidity. Besides being an important differential diagnosis for patients with progressive myelopathy [7,14,27], there is some evidence that people with progressive MS are more susceptible to cervical spinal stenosis [37]. This stresses the need to perform and critically review an MRI spinal cord in patients suspected of PPMS, especially since cervical spine decompression can improve myelopathy, neck pain and radiculopathy in patients with coexistent cervical stenosis and MS [38].…”

Diagnostic overshadowing: An evolutionary concept analysis on the misattribution of physical symptoms to pre‐existing psychological illnesses

“…The term then took on the meaning of physical illness misattributed to comorbid mental illness. The term now appears in descriptions of the misdiagnosis of one physical malady as being caused by a different, already diagnosed physical illness (Agaronnik et al 2021;Barnett et al 2021;Chhugani et al 2021;Iezzoni 2019). Further developments may occur if diagnostic overshadowing achieves wider recognition within the realm of healthcare biases (Hinde et al 2021;Jamieson & Mason 2019;Molloy et al 2021a,b).…”

“… 2021 ; Chhugani et al . 2021 ; Iezzoni 2019 ). Further developments may occur if diagnostic overshadowing achieves wider recognition within the realm of healthcare biases (Hinde et al .…”

“…The term has since evolved to encompass misattribution of one undiagnosed mental illness to an already diagnosed, comorbid mental illness (Becker-Haimes et al 2021;Kaufman & Baucom 2014). More recently, diagnostic overshadowing has been used to describe symptoms of undiagnosed physical illness attributed to comorbid physical ailments (Agaronnik et al 2021;Barnett et al 2021;Chhugani et al 2021;Iezzoni 2019).…”