Document resource
The differential diagnosis of inflammatory central nervous system (CNS) diseases poses a significant challenge, particularly when distinguishing multiple sclerosis (MS) from systemic immune-mediated diseases with CNS involvement, such as systemic lupus erythematosus, Sjögren’s syndrome, and sarcoidosis. This presentation will explore key clinical, imaging, and laboratory features that help differentiate these entities. It will also address pitfalls in diagnosis, including the potential for overlapping syndromes and false-positive or false-negative MRI and CSF findings. Finally, we will discuss novel biomarkers and emerging diagnostic tools that might help to improve the diagnostic approach and enable the correct treatment of patients.Learning Objectives At the end of this presentation participants will be able to:Recognize the clinical and paraclinical features that distinguish MS from systemic immune-mediated diseases affecting the CNSDescribe common diagnostic pitfalls and strategies to avoid misclassificationDiscuss current and emerging biomarkers that may aid in differential diagnosisReferences Konen FF, Möhn N, Witte T, et al. Treatment of autoimmunity: the impact of disease-modifying therapies in multiple sclerosis and comorbid autoimmune disorders. Autoimmun Rev. 2023;22(5):103312. doi: 10.1016/j.autrev.2023.103312Seeliger T, Kramer E, Konen FF, et al. Sjögren’s syndrome with and without neurological involvement. J Neurol. 2023;270(6):2987–96. doi: 10.1007/s00415-023-11613-5Tenembaum S, Hartung HP. Multiple sclerosis: Advances and challenges in diagnosis. Curr Opin Neurol. 2025;38(3):197–204. doi: 10.1097/wco.0000000000001366