Epilepsy, multiple sclerosis or brain tumor, can you tell them apart?

According to statistics, about 2 million people die from malignant tumors in my country every year, among which the incidence of intracranial tumors is 7-9/100,000 people per year, which means that there is less than one intracranial tumor patient in every 10,000 people, and 40%-50% of these patients suffer from malignant tumors.

Brain tumor misdiagnosed as epilepsy:

Some brain tumor patients have epilepsy as the first symptom. Epilepsy is the only symptom 2-3 years, or even 5-10 years before the other typical symptoms of brain tumor appear. In the early stage of the disease, 80%-90% do not have obvious symptoms of increased intracranial pressure such as headache and vomiting, and most of them do not have papilledema. Therefore, this type of epilepsy is often misdiagnosed as primary epilepsy and treated symptomatically for a long time, which delays the best time to treat brain tumors.

Brain abscess misdiagnosed as brain tumor:

Brain abscess is a common intracranial infectious disease. The incidence of cryptogenic brain abscess has been increasing in recent years. It is characterized by a long medical history, mild infection symptoms, and tumor-like imaging, which can easily lead to misdiagnosis as a brain tumor.

Although brain abscess has a space-occupying effect, patients often have infection foci, fever at onset, and signs of meningeal irritation. Peripheral blood shows leukocytosis, and inflammatory cells are present in the cerebrospinal fluid. CT scans often show round or oval low-density shadows, and enhanced scans show thin-walled and smooth ring enhancements, which are significantly different from brain tumors.

Differentiation between brain tumor and multiple sclerosis:

Multiple sclerosis is a common type of demyelination, characterized by diffuse axonal demyelination and gliosis. It often occurs around the ventricles, optic nerves, brainstem, cerebellar white matter and cerebellar peduncles, and spinal cord, and sometimes needs to be differentiated from intracranial tumors, especially gliomas.

It is not difficult to distinguish typical multiple sclerosis from brain glioma clinically. However, for single-stage multiple sclerosis with only a single lesion and intracranial space-occupying effect, the clinical manifestations are almost the same as those of brain tumors, and differential diagnosis is very difficult. Relevant MRI, CT and other examinations should be performed for differentiation.