McDonald Criteria

Okay, so armed with a “probable Ms” diagnosis after leaving my Neurologists office last week, I have been reading up on MS. I am at the point now where my non-medically trained brain is having a hard time understanding the McDonald Criteria. In short, I have had two MRI’s that show non-enhancing lesions, more on the 2nd one that was done 6 months after the first. Only clinical symptoms have been a slight hand tremor that comes and goes and dizziness that also comes and goes. VEP, CSF and bloodwork have all been normal.

This is the link to the McDonald Criteria I have been using: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/multsclerosis/table1ms.htm

So, the way I read it, you pick the row in the first column that applies to you and then you have to meet the supporting stuff in the second column of that same row. For the first column, do lesions on am MRI qualify for “objective clinical evidence of a lesion”? Also, what qualifies as an “attack”. I haven’t really had major clinical symptoms, but wouldn’t the fact that I have had two MRI’s that showed lesions on the first MRI, and new ones on the 2nd, prove that I’ve had an attack?

I understand the general concept that you have to dissemination in time and space, but it seems that the criteria is all based on presentation of clinical symptoms. I really didn’t present with clinical symptoms, but instead my lesions were discovered on accident on a CT scan first. My symptoms have been so mild and infrequent that I am not sure I would have noticed them had I not been aware of the original MRI results.

Anyway, the gist is that I am having trouble interpreting the criteria and how to use the chart. Any help would be great. Thanks - Amy

[6-paq]

Quix has a really good write-up on the McDonald criteria.  I'll see if I can find it.

Pat