Dr Daniel Kantor Discusses the Troubling Occurrence of MS Underdiagnosis

While there are concerns about the overdiagnosis of multiple sclerosis (MS), underdiagnosis is also a serious problem that can lead to patients not receiving treatment for MS, explained Daniel Kantor, MD, president of Kantor Neurology.

Transcript

Multiple sclerosis is difficult to diagnose, and symptoms can be misdiagnosed. What issues might cause a late diagnosis of MS?

There has been a lot of focus lately on the overdiagnosis of multiple sclerosis. I started an organization in 2009, 2010 that at first was very regional—it was called the Southeastern MS Consortium. We’ve ballooned to over 1300 members; that means a third of the prescribers of these disease-modifying therapies in the United States are members of the Medical Partnership 4 MS, or MP4MS.

One of the frustrations that people who take care of a lot of patients with multiple sclerosis feel is that there’s been focus at these large meetings on overdiagnosis. What about the underdiagnosis of multiple sclerosis? That can be troubling as well. It can mean that a person could have symptoms and could have problems and they are shifted from doctor to doctor to doctor, and nothing is happening. In the meantime, they’re having damages to their central nervous system, they’re having neuroinflammation, they’re having neurodegeneration, they’re even having accumulation of disability.

What we’re going to be looking at over the next year is not just at the overdiagnosis of multiple sclerosis, but also the underdiagnosis of multiple sclerosis. What are the barriers, and some of them are systems barriers, some of them are educational barriers, other ones just have to do with the disease itself. MS is sometimes a difficult-to-diagnose disease, and that means that it can be confusing to any sort of neurologist who is seeing it. But some of these patients have very clear and classic symptoms, but they’re not getting to see the right physician. And so what we want to do is make sure that we don’t just focus on the overdiagnosis, we also look at the underdiagnosis, especially in a disease like multiple sclerosis, where now we have therapies that can actually change people’s lives.