Moyamoya: Another multiple sclerosis mimic

A broad range of disorders have been recognized to share clinical and radiographic features with multiple sclerosis and are frequently mistaken with this diagnosis. Several of these disorders are vascular disorders, including atherosclerotic and inflammatory diseases affecting small and medium sized vessels, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and migraine variants. We describe 2 patients with moyamoya syndrome who presented with paroxysmal symptoms, physical findings and MRI abnormalities that were mistaken for multiple sclerosis. Therefore, moyamoya must be added to the list of disorders in the differential diagnosis of multiple sclerosis.