What is McDonald diagnostic criteria for multiple sclerosis?

Under the McDonald Criteria (revised), an MS diagnosis is likely if myelin damage is disseminated in space, as seen in an MRI as: At least one T2 bright lesion in at least two or four CNS locations: the juxtacortical, perventricular and infratentorial areas of the brain, and the spinal cord.

What is objective clinical evidence in MS?

Relapsing MS diagnosis requires objective clinical evidence of two or more CNS lesions (dissemination in space) that have occurred at different times (dissemination in time), or objective clinical evidence of one lesion with reasonable historical evidence of a prior attack.

What does MS diagnosis require?

In order to make a diagnosis of MS, the physician must: Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND. Find evidence that the damage occurred at different points in time AND. Rule out all other possible diagnoses.

What is dissemination in space in multiple sclerosis?

Dissemination in space is defined as the development of lesions in distinct anatomic locations within the central nervous system, indicating a multifocal process.

Does MS always show up on brain scan?

MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a “negative” scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.

Can MRI Miss MS lesions?

The magnetic resonance imaging (MRI) may show areas of abnormality that suggest MS, though the MRI in and of itself does not make the diagnosis. Spinal fluid testing may show that the immune system is active in and around the brain and spinal cord, supporting the diagnosis.

What is McDonald criteria for multiple sclerosis?

McDonald criteria. The McDonald criteria are diagnostic criteria for multiple sclerosis (MS). These criteria are named after neurologist W. Ian McDonald who directed an international panel in association with the National Multiple Sclerosis Society (NMSS) of America and recommended revised diagnostic criteria for MS in April 2001.

What are the benefits of the McDonald criteria revisions?

The McDonald Criteria revisions enable more rapid diagnosis of MS and thus permit earlier treatment of MS. For clinical research trials, the McDonald Criteria ensure that those without a definite diagnosis of MS are not enrolled.

What is the specificity of the McDonald criteria?

Specificity of the McDonald criteria is low due to the fact that the nature of the lesions is not considered, but only their dissemination. None of the criteria are MS-specific. In order to reduce false positives, McDonald et al. propose that their criteria should be applied only after any other disease has been ruled out.

When did McDonalds start using McDonald criteria?

McDonald criteria were originally introduced in 2001 1, revised in 2005 2, 2010 3, 2016 (by MAGNIMS) 4 and most recently in 2017 5. The 2017 revision is presented above.