Early symptoms of multiple sclerosis (MS) often present as clear, localized neurological changes lasting several days. However, many nonspecific complaints and common MRI findings can mimic MS, leading to misdiagnosis and unnecessary treatment. Dr. Jonathan Howard, an Associate Professor of Neurology and Psychiatry at the NYU Grossman School of Medicine and the Director of the Neurology Service at Bellevue Hospital, reviews hallmark symptom patterns, explains how to differentiate benign MRI changes from true disease, and underscores the importance of thorough history-taking, neurological exams, and targeted testing to ensure accurate diagnosis and optimal patient care.