What are best practices to avoid misdiagnosis of multiple sclerosis in patients over 50 years old?

The onset of MS in patients over 50 years old is unusual. At the same time, there are a greater number of conditions, many of them quite common (i.e., chronic microvascular disease), that cause white matter disease that can mimic MS in patients over 50 years. Given that MS incidence is less and MS m...

A stringent application of the new diagnostic criteria for MS, harping on "no better explanation," is key to avoiding misdiagnosis. The MRI over age 50 becomes more unreliable as non-specific white matter lesions become more prominent. If MS is clinically suspected, then a proper MRI sequence to sea...