title: Moyamoya disease can masquerade as multiple sclerosis.
abstract: BACKGROUND
  Moyamoya disease (MM) is a rare disorder of the cerebral arterial circulation, whereas multiple sclerosis (MS) is a relatively common immune-mediated attack on central myelin. Despite the differences in pathogenesis, the 2 disorders share some clinical features which can lead to diagnostic confusion: both can affect young adults, cause intermittent neurological symptoms, and show multifocal abnormalities on brain imaging.
  
  
  OBJECTIVE
  To emphasize the need for early consideration of MM in the differential diagnosis of MS-spectrum disorders.
  
  
  METHODS
  Chart reviews and individual case analyses.
  
  
  RESULTS
  We present detailed descriptions of 3 patients with MM, and summary data on 8 additional cases, in which there was diagnostic confusion with MS, with delays in treatment ranging from 2 months to 19 years (median=4 y).
  
  
  CONCLUSIONS
  MM can be misdiagnosed as MS, leading to delay in correct treatment. We highlight the clinical and radiologic features which allow differentiation of these conditions early in the course, when treatment can have maximum benefit.
authors.affiliation: Departments of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA. ldorfman@stanford.edu
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Dorfman
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Fischbein
authors.forename: Joslyn I
authors.initials: JI
authors.lastname: Woodard
authors.forename: Omar
authors.initials: O
authors.lastname: Choudhri
authors.forename: Teresa E
authors.initials: TE
authors.lastname: Bell-Stephens
authors.forename: Gary K
authors.initials: GK
authors.lastname: Steinberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000473:pathology; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult