McDonald criteria
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2008-05-28T07:26:29Z
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The '''McDonald criteria''' are diagnostic criteria for [[multiple sclerosis]]. In April 2001 an international panel in association with the National Multiple Sclerosis Society (NMSS) of [[United States|America]] recommended revised diagnostic criteria for ms.<ref name="pmid11456302">{{cite journal |author=McDonald WI, Compston A, Edan G, ''et al'' |title=Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis |journal=[[Ann. Neurol.]] |volume=50 |issue=1 |pages=121–7 |year=2001 |pmid=11456302 |doi= |url=}}</ref> 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.<ref name="pmid16283615">{{cite journal |author=Polman CH, Reingold SC, Edan G, ''et al'' |title=Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria" |journal=[[Ann. Neurol.]] |volume=58 |issue=6 |pages=840–6 |year=2005 |pmid=16283615 |doi=10.1002/ana.20703}}</ref>
==Diagnostic Criteria==
{| class="wikitable"
|-
! Clinical Presentation
! Additional Data Needed
|-
| * 2 or more attacks (relapses) <br /> * 2 or more objective clinical lesions
| None; clinical evidence will suffice (additional evidence desirable but must be consistent with MS)
|-
| * 2 or more attacks <br /> * 1 objective clinical lesion
| Dissemination in space, demonstrated by: <br /> * MRI <br /> * or a positive CSF and 2 or more MRI lesions consistent with MS <br /> * or further clinical attack involving different site
|-
| * 1 attack <br /> * 2 or more objective clinical lesions
|Dissemination in time, demonstrated by:<br /> * MRI <br /> * or second clinical attack
|-
| * 1 attack <br /> * 1 objective clinical lesion <br />(monosymptomatic presentation)
|Dissemination in space demonstrated by: <br /> * MRI <br /> * or positive CSF and 2 or more MRI lesions consistent with MS<br />'''and'''<br />Dissemination in time demonstrated by:<br /> * MRI<br /> * or second clinical attack
|-
|Insidious neurological progression<br /> suggestive of MS<br /> (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==
{{reflist}}
{{Multiple sclerosis}}
{{Diseases of the nervous system}}
[[Category:Neurology]]
[[Category:Autoimmune diseases]]
[[Category:Neurological disorders]]
[[Category:multiple sclerosis]]
[[de:Diagnosekriterien der Multiplen Sklerose]]