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International panel revises 'McDonald Criteria' for diagnosing multiple sclerosis
Date:3/9/2011

maintain this requirement, but offer several ways of using imaging to determine dissemination. It remains the case that while the use of paraclinical and laboratory examination can speed an MS diagnosis, a solid diagnosis can be made on clinical grounds alone.

No single test can provide adequate information to support an MS diagnosis. Therefore, supportive and confirmatory paraclinical examinations including analysis of lesions by MRI, of cerebrospinal fluid (CSF), and sometimes of evoked potentials are still important in helping to confirm an MS diagnosis.

What Has Changed: There is new emphasis that the McDonald Criteria should only be applied to those who present with a clinically isolated syndrome (CIS) suggestive of MS, or who have symptoms consistent with a central nervous system inflammatory demyelinating disease. The panel also considered how well the Criteria can be applied to specific populations such as childhood MS (pediatric MS) and Asian and Latin American populations. They concluded that the 2010 Revised Criteria would apply to the majority of these populations, but the paper describes specific situations in which further considerations and tests would be recommended to properly diagnose MS in these groups.

In past versions of the McDonald Criteria, guidelines were presented for using MRI to demonstrate dissemination of disease in time and space, based on earlier studies. For the 2010 Revised Criteria, published recommendations from the European MAGNIMS multicenter collaboration have been incorporated (Swanton JK, Rovira A, Tintor M, et al. Lancet Neurol 2007;6:677-686; Swanton JK Fernando K, Dalton CM, et al. J Neurol Neurosurg Psychiatry 2006;77:830-833.) These indicate that:

  • Dissemination in time can be demonstrated by a new T2 or gadolinium-enhancing lesion on a follow-up MRI, with reference to a baseline scan, regardless of when the baseline MRI was obtained. (Previous versions had specified that the refe
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Contact: Arney Rosenblat
arney.rosenblat@nmss.org
212-476-0436
National Multiple Sclerosis Society
Source:Eurekalert

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