diagnostic Parameters for Multiple Sclerosis

Diagnostic Criteria for Multiple Sclerosis
In April, 2001, an international panel in association with the NMSS of America recommended revised diagnostic criteria for multiple sclerosis. These new criteria have become known as the McDonald criteria after their lead author. They make use of advances in MRI imaging techniques and are intended to replace the Poser Criteria and the older Schumacher Criteria. The new revised criteria are as follows:

Clinical Presentation Additional Data Needed
2 or more attacks (relapses)
2 or more objective clinical lesions
None; clinical evidence will suffice
(additional evidence desirable but must be consistent with MS)
2 or more attacks
1 objective clinical lesion
Dissemination in space, demonstrated by:
MRI
or a positive CSF and 2 or more MRI lesions consistent with MS
or further clinical attack involving different site
1 attack
2 or more objective clinical lesions
Dissemination in time, demonstrated by:
MRI
or second clinical attack
1 attack
1 objective clinical lesion
(monosymptomatic presentation) Dissemination in space by demonstrated by:
MRI
or positive CSF and 2 or more MRI lesions consistent with MS
and
Dissemination in time demonstrated by:

MRI
or second clinical attack
Insidious neurological progression
suggestive of MS
(primary progressive MS) Positive CSF
and

Dissemination in space demonstrated by:

MRI evidence of 9 or more T2 brain lesions
or 2 or more spinal cord lesions
or 4-8 brain and 1 spinal cord lesion
or positive VEP with 4-8 MRI lesions
or positive VEP with <4 brain lesions plus 1 spinal cord lesion
and
Dissemination in time demonstrated by:

MRI
or continued progression for 1 year