How do you tell the difference between multiple sclerosis and chiari malformation?

MRI: Chiari is a malformation of the cerebellum and brainstem that is well defined by mri. There are at least three types depending on the appearance of the base of the cerebellum. Multiple sclerosis is a disease of the white matter of the brain that is multifocal and can be seen well by MRI and by tests on the spinal fluid. A good neurologist can easily identify the difference.

Simplest approach: An MRI of brain and upper cervical spinal cord will demonstrate the presence of a Chiari Malformation, and if MS, typical lesions will be present within the white matter in a classical distribution.