Editing Multiple sclerosis (section)

=== Differential diagnosis ===
Several diseases present similarly to MS.<ref name="Loscalzo-2022" /><ref name="Saguil-2022" /> Medical professionals use a patient's specific presentation, history, and exam findings to make an individualized [[Differential diagnosis|differential]]. Red flags are findings that suggest an alternate diagnosis, although they do not rule out MS. Red flags include a patient younger than 15 or older than 60, less than 24 hours of symptoms, involvement of multiple [[cranial nerves]], involvement of organs outside of the [[nervous system]], and atypical lab and exam findings.<ref name="Loscalzo-2022">{{Cite book | vauthors = Hauser SL | chapter = Chapter 442: Diseases of the Spinal Cord | veditors = Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL  |title=Harrison's principles of internal medicine |date=2022 |isbn=978-1-264-26849-8 |edition=21st |location=New York | publisher = McGraw-Hill |oclc=1282172709 | page = 3466 }}</ref><ref name="Saguil-2022">{{cite journal | vauthors = Saguil A, Farnell IV EA, Jordan TS | title = Multiple Sclerosis: A Primary Care Perspective | journal = American Family Physician | volume = 106 | issue = 2 | pages = 173–183 | date = August 2022 | pmid = 35977131 | url = https://www.aafp.org/pubs/afp/issues/2022/0800/multiple-sclerosis.html }}</ref>

In an emergency setting, it is important to rule out a stroke or [[Intracranial hemorrhage|bleeding]] in the brain.<ref name="Saguil-2022" /> Intractable vomiting, severe optic neuritis,<ref name="Petzold_2022" /> or bilateral optic neuritis<ref name="Petzold_2022" /> raises suspicion for [[neuromyelitis optica spectrum disorder]] (NMOSD).<ref name="Solomon2019DiagnosisReview">{{cite journal | vauthors = Solomon AJ | title = Diagnosis, Differential Diagnosis, and Misdiagnosis of Multiple Sclerosis | journal = Continuum | volume = 25 | issue = 3 | pages = 611–635 | date = June 2019 | pmid = 31162308 | doi = 10.1212/CON.0000000000000728 | s2cid = 173991777 }}</ref> Infectious diseases that may look similar to multiple sclerosis include HIV, [[Lyme disease]], and [[Neurosyphilis|syphilis]]. Autoimmune diseases include [[neurosarcoidosis]], [[lupus]], [[Guillain–Barré syndrome|Guillain-Barré syndrome]], [[acute disseminated encephalomyelitis]], and [[Behçet's disease]]. Psychiatric conditions such as [[Generalized anxiety disorder|anxiety]] or [[conversion disorder]] may also present in a similar way. Other rare diseases on the differential include [[Primary central nervous system lymphoma|CNS lymphoma]], [[Leukodystrophy|congenital leukodystrophies]], and [[MOG antibody disease|anti-MOG-associated myelitis]].<ref name="Loscalzo-2022" /><ref name="Saguil-2022" />