Background: Multiple sclerosis (MS) is a chronic autoimmune disease which is the main cause of non-traumatic disability among young and middle-aged adults. The diagnosis of MS is not often feasible, whereas many disorders are mimicking MS.
Objective: retrieving the difference in demographics, clinical, and paraclinical characteristics of MS mimics in order to ensure early diagnosis and adequate treatment of such patients.
Patients and Methods: All patients with clinically suspected MS and aged 18-60 years old were included in the current study from the MS unit of Neurology Department, Al-Azhar University Hospitals, during the period from May, 2017 to April, 2019. Those patients were furtherly assorted based on Mcdonald's Criteria 2017 and paraclinical assessment into two groups; patients who had confirmed MS and those with MS mimics.
Results:  In the present study, 515 patients with a suspected diagnosis of multiple sclerosis were enrolled. There were 400 (77.6 %) patients diagnosed as MS, while 115 (22.4%) patients were not fulfilling such criteria and considered MS mimics.
      After reaching a final diagnosis, our cases distributed as follows: Thirty cases (26.1) migraine, twelve cases (10.4%) radiological isolated syndrome, eleven cases (9.6%) small vessel disease, ten cases (8.7%) psychogenic, eight cases (7%) neuromyelitis optica, five cases (4.3%) systemic lupus erythematosus, five cases (4.3%) Behcet's disease, five cases (4.3%) anterior ischemic optic neuropathy, four cases (3.5%) antiphospholipid syndrome, and four cases (3.5%) transverse myelitis.
Conclusion: Patients with a suspected diagnosis of MS should be subjected to meticulous neurological assessment coupled with MRI and the appropriate laboratory investigations to reach the definite diagnosis.