Christina Applegate misdiagnosis highlights MS complexities
Emmy Award-winning actress Christina Applegate, known for her roles in Married... with Children, Anchorman and Netflix's Dead to Me, recently revealed a surprising development in her health journey.
After publicly announcing her multiple sclerosis (MS) diagnosis in 2021 and becoming a prominent advocate for people living with the disease, Applegate revealed on her MeSsy podcast that her doctor recently told her she does not have MS, reversing a diagnosis she received more than five years ago.
The 54-year-old actress continues to experience debilitating symptoms, leaving her medical team searching for answers.
Her experience highlights the challenges of diagnosing MS, a disease that can resemble several other neurological conditions.
Douglas Juvinall, MD, is a fellowship-trained neurologist who specializes in multiple sclerosis at OSF HealthCare Illinois Neurological Institute, a National Multiple Sclerosis Society-designated center recognized for providing comprehensive MS care.
"There is not a single blood test or MRI finding that definitively tells you this is MS," Dr. Juvinall says. "The criteria requires a constellation of MRI findings. Some other diseases can sometimes show you similar findings, and it takes someone with expertise in those other conditions to help exclude other conditions that aren't MS."
Why is MS difficult to diagnose?
Multiple sclerosis is an autoimmune disease that causes inflammation and damage to nerves throughout the central nervous system, which includes the brain and spinal cord.
Symptoms can include vision loss, double vision, numbness, weakness, severe fatigue and bladder dysfunction. However, these symptoms can also occur with other conditions, making an accurate diagnosis more challenging.
"The symptoms of MS are not unique to MS, they can occur in many other conditions," Dr. Juvinall says. "The MRI findings in MS can be unique to MS if interpreted correctly by a neurologist who specializes in MS, or a neuroradiologist. But sometimes those findings can be very subtle and can lead to a misdiagnosis."
According to the Multiple Sclerosis International Federation, early symptoms can be vague and occur sporadically over time. Reaching a diagnosis can take months or longer, even when symptoms appear consistent with MS.
In some cases, rarer diseases can mimic MS and produce similar findings on an MRI scan. Dr. Juvinall emphasizes the importance of working with a neurologist who specializes in MS, along with a multidisciplinary team experienced in identifying other conditions.
Part of that process involves reviewing medical history, imaging and other diagnostic tests to rule out diseases that could be responsible for the symptoms.
Why an accurate diagnosis matters
Someone incorrectly diagnosed with MS may undergo treatments that aren't addressing the actual cause of their symptoms. Learning that a diagnosis was incorrect can also bring frustration and uncertainty, particularly when symptoms remain unexplained.
Applegate expressed similar feelings on her podcast, saying she is back at square one in trying to understand her health.
Dr. Juvinall says there are more than 20 treatments approved by the U.S. Food and Drug Administration (FDA) for MS. While these medications can be highly effective, some can increase the risk of infections and other complications.
That makes confirming the diagnosis essential to developing an appropriate treatment plan.
"I believe it's very important (to see an MS specialist) because neurologists who have training or expertise in dealing with multiple sclerosis, will have had more cases of seeing the disease," Dr. Juvinall says. "As well as more expertise in finding those diseases that can mimic MS."
For people experiencing symptoms that could be related to MS, seeking an evaluation from a neurologist with expertise in the disease can be an important step toward finding answers and receiving appropriate care.