McDonald criteria
The McDonald criteria are diagnostic criteria for multiple sclerosis (MS). In April 2001 an international panel in association with the National Multiple Sclerosis Society (NMSS) of America recommended revised diagnostic criteria for MS.[1] They make use of advances in MRI imaging techniques and are intended to replace the Poser criteria and the older Schumacher criteria. The new criteria facilitate the diagnosis of MS in patients who present with signs and symptoms suggestive of the disease. These include monosymptomatic disease, disease with a typical relapsing-remitting course or insidious progression but no clear attacks and remissions.
The McDonald criteria for the diagnosis of multiple sclerosis were revised in 2005 to clarify exactly what is meant by an "attack," "dissemination," a "positive MRI," etc.[2]
Diagnostic Criteria
| Clinical Presentation | Additional Data Needed |
|---|---|
| * 2 or more attacks (relapses) * 2 or more objective clinical lesions |
None; clinical evidence will suffice (additional evidence desirable but must be consistent with MS) |
| * 2 or more attacks * 1 objective clinical lesion |
Dissemination in space, demonstrated by: * MRI * or a positive CSF and 2 or more MRI lesions consistent with MS * or further clinical attack involving different site |
| * 1 attack * 2 or more objective clinical lesions |
Dissemination in time, demonstrated by: * MRI * or second clinical attack |
| * 1 attack * 1 objective clinical lesion (monosymptomatic presentation) |
Dissemination in space demonstrated by: * MRI * or positive CSF and 2 or more MRI lesions consistent with MS and Dissemination in time demonstrated by: * MRI * or second clinical attack |
| Insidious neurological progression suggestive of MS (primary progressive MS) |
One year of disease progression (retrospectively or prospectively determined) and
Two of the following: a. Positive brain MRI (nine T2 lesions or four or more T2 lesions with positive VEP) b. Positive spinal cord MRI (two focal T2 lesions) c. Positive CSF |
References
- ^ McDonald WI, Compston A, Edan G; et al. (2001). "Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis". Ann. Neurol. 50 (1): 121–7. doi:10.1002/ana.1032. PMID 11456302.
{{cite journal}}: Explicit use of et al. in:|author=(help)CS1 maint: multiple names: authors list (link) - ^ Polman CH, Reingold SC, Edan G; et al. (2005). "Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria"". Ann. Neurol. 58 (6): 840–6. doi:10.1002/ana.20703. PMID 16283615.
{{cite journal}}: Explicit use of et al. in:|author=(help)CS1 maint: multiple names: authors list (link)