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A common error is to over-interpret multiple hyperintense lesions on MRI as equivalent to MS in the absence of clinical symptoms consistent with the diagnosis. Some central nervous system inflammatory or infectious diseases may produce multifocal lesions with or without a relapsing-remitting course, including the following:
●Systemic lupus erythematosus, which can present as a recurrent neurologic syndrome before the systemic manifestations appear
●Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
●Susac syndrome, a rare microangiopathy characterized by the triad of encephalopathy, branch retinal artery occlusions and hearing loss