diagnosis

Information, Symptoms, Treatments and Resources

Blank
Diagnosing MS - The McDonald Criteria (Revised 2005) CHART
visit the
MS Information Index
  visit the
MS Community
Information Index MS 
Community Information & Resourses
Community

 2005 Revised McDonald MS Diagnostic Criteria 1

 

 Source: National Multiple Sclerosis Society 2008

 

 

 

 

This is a quick reference chart.  For a detailed and thorough explanation please see Health Page: Diagnosing MS - The McDonald Criteria (revised 2005) "The Myth of the 9 Lesions"

 

Clinical

(Attacks) 

Objective

Lesions 

Additional Requirements to make DX 
2 or more

2 or more

None. Clinical evidence alone will suffice; additional evidence desirable but must be consistent with MS

2 or more 1 Dissemination in space by MRI or 2 or more MRI lesions consistent w/MS plus positive CSF or await further clinical attack implicating other site
1 2 or more Dissemination in time by MRI or second clinical attack
1 1

Dissemination in space by MRI or 2 or more MRI lesions consistent with MS plus positive CSF 

AND dissemination in time by MRI or second clinical attack

 0

 (progression from onset)

 1 or more

Disease progression for 1 year (retrospective or prospective) AND 2 out of 3 of the following:

  • Positive brain MRI (9 T2 lesions or 4 or more T2 lesions with positive VEP)
  • Positive spinal cord MRI (2 or more focal T2 lesions)
  • Positive CSF
     
     

 

 

1Polman et al. Diagnostic Criteria for Multiple Sclerosis: 2005 Revisions to the "McDonald" Criteria.  Annals of Neurology (2005) 58: 840-846

 

 

Paraclinical Evidence in MS Diagnosis

 

 

 

 

What is a Positive

MRI Showing Dissemination in Space?2,3

 

What Provides MRI Evidence of Dissemination in Time?

3 out of 4 of the following:

  • 1 Gd-enhancing brain or cord lesion or 9 T2 hyperintense brain and/or cord lesions if there is no Gd-enhancing lesion
  • 1 or more brain infratentorial or cord lesions
  • 1 or more juxtacortical lesions
  • 3 or more periventricular lesions

NOTE: Individual cord lesions can contribute along with individual brain lesions to reach required number of T2 lesions.

  • A Gd-enhancing lesion detected in scan at least 3 months after onset of initial clinical event at a site different from initial event

                -- or --

  • A new T2 lesion detected in a scan done at any time compared to a reference scan done at least 30 days after initial clinical event

 

What is Positive CSF?  2 or more Oligoclonal IgG bands in CSF (and not serum) or elevated IgG index
What is Positive VEP?  Delayed arrival of signal, but well-preserved wave form

2Barkhof et al. Brain (1997) 120: 2059-2069

3Tintore' et al. Am J Radiology (2000) 21: 702-706

 

 

These diagnostic criteria were developed through the consensus of the International Panel on the Diagnosis of MS.  See cited articles (above) for details.

About this page
Rating
MedHelp Health Answers