[MUS] are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected [MS] 2024 Novakova+

Full title: Medically unexplained symptoms are common in women in tertiary neurological healthcare center: A survey cohort study of persons investigated for suspected multiple sclerosis

Abstract

Background
A significant proportion of individuals with suspicious onset of multiple sclerosis (MS) does not fulfill the diagnostic criteria. Although some receive other diagnoses, many remain undiagnosed and lack healthcare follow-up. This study aimed to characterize persons with undetermined diagnosis (PwUD) through a questionnaire.

Methods
Incident cases with suspected MS were consecutively admitted to a tertiary neurological healthcare center in a prospective cohort study. Those who remained undiagnosed after 40 months (mean, range 31–52) were considered PwUD. They completed a modified questionnaire, previously used in a population-based case-control study of incident MS cases. Their responses were compared with two control cohorts, persons with MS (PwMS) and healthy controls, randomly selected from national registries, matched by age, gender, and area of residence.

Results
Out of 271 patients with suspected MS onset, 72 (20.3%) were PwUD with a female majority (79%). The response rate was 83% and 39% reported persisting MS-like symptoms. Compared to controls (n = 548) and PwMS (n = 277), fewer PwUD were currently smoking (p = .4 and p = .03), consumed less alcohol (p = .04 and p = .01), and had children (p = .02 and p = .002). PwUD reported occurrence of other autoimmune disease in 29%, higher compared to PwMS and controls (p < .001 and p < .001).

Conclusions
UD is common among persons investigated for suspected MS, in particular among female parents. Our data suggest that PwUD can be characterized as nonsmokers with low alcohol consumption and a higher prevalence of autoimmune disease, in particular thyroid disease.

Open access, https://onlinelibrary.wiley.com/doi/10.1002/brb3.3459

 

In the Introduction, the very first sentence is :

What is a suspicious onset of MS?
And what is a non-suspicious onset of MS?

 

My knowledge of MS is very much out of date, but my understanding is that its initial presentation can be very very variable and more than one episode is required for a formal diagnosis, making it inevitable that a lot of not yet understood neurological issues will initially be considered as potentially MS. So surely the word ‘suspicious’ should not be used in this context in relation to the onset, rather it should be attached to the MS, ‘neurological symptoms where MS is a suspected cause’.

This wording ‘suspicious onset’ in this abstract can only be seen as part of the pejorative casting of MUS, even when used properly to describe some one yet to be diagnosed rather than the widespread misuse as a euphemism for conversion disorders.

[added - not sure if I communicated my point clearly: ‘because of its very nature there is uncertainty in the onset of MS so it is inevitable that other known and unknown conditions will get caught up at this point, so this wording is inappropriately judgemental about those that ultimately turn out to not have MS. This is particularly important as use of such as ‘MUS’ can result in stopping investigation with potentially serious if not fatal adverse consequences’.]

 

How would I know if I have MS? Genuine question. As far as I can tell it’s picked up via testing, but I’ve never been tested. It’s never been considered as a possible cause of my symptoms, but people frequently ask if I’ve got MS because I’m just like this or that person who has it.

 

So, in a MS clinic, patients suspected to have MS based on having MS-like symptoms without a definitive explanation, 17% of which received an alternative diagnosis, some are found to have MS-like symptoms based on asking them about MS-like symptoms even though the diagnosis cannot be confirmed using modern technology.

And in a disease with an approximate 4:1 ratio of female:male, they also find the same ratio in this cohort, and find it necessary to emphasize the fact like it's some surprising find. A disease defined by many non-specific symptoms with a history of having been misrepresented as ye olde "MUS", which is simply the modern label for ye olde hysteria.

Groundbreaking stuff. Water, suspected to have water-like properties based on presence of water-like properties, confirmed to have water-like properties by looking at whether they have water-like properties.

Scientists look at things they don't understand and are driven to understand them. Medical doctors, it seems, prefer to default to the old "must be the magics" of pre-science days.

 

Ah that reminds me, I must try homeopathy to see if that cures me.

 

Same question here.

To be brief I had my first ms episode about 4 years ago when I had a attack and ended up paralyzed from the chest down. All the MRIs where clear but I had elevated protein levels in CSF fluid.
One neuro wanted to diagnose me as fnd but I told him about the elevated levels he did not want to know.
So here I am today wanting answers.
That's why I think fnd is totally crap.