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    McDonald Criteria Multiple Sclerosis

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    Resa Budi Deskianditya
    The McDonald criteria are the diagnostic standards used to diagnose multiple sclerosis (MS). They were introduced in 2001 and revised in 2005 and 2010 to improve sensitivity while maintaining specificity. The criteria require evidence of lesions in the central nervous system disseminated in both space (lesions in at least two areas of the brain or spinal cord) and time (new lesions on follow up MRI or simultaneous active and inactive lesions). This establishes MS as a disease with more than one lesion and more than one attack. The 2010 revisions improved sensitivity to 77% while maintaining high specificity at 92% for an overall accuracy of 86% in MS diagnosis.

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    McDonald Criteria Multiple Sclerosis

    Uploaded by

    Resa Budi Deskianditya
    177 views5 pages
    The McDonald criteria are the diagnostic standards used to diagnose multiple sclerosis (MS). They were introduced in 2001 and revised in 2005 and 2010 to improve sensitivity while maintaining specificity. The criteria require evidence of lesions in the central nervous system disseminated in both space (lesions in at least two areas of the brain or spinal cord) and time (new lesions on follow up MRI or simultaneous active and inactive lesions). This establishes MS as a disease with more than one lesion and more than one attack. The 2010 revisions improved sensitivity to 77% while maintaining high specificity at 92% for an overall accuracy of 86% in MS diagnosis.

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    Kriteria Mc Donald untuk diagnosis Multiple Sclerosis

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    The McDonald criteria are the diagnostic standards used to diagnose multiple sclerosis (MS). They were introduced in 2001 and revised in 2005 and 2010 to improve sensitivity while maintaining specificity. The criteria require evidence of lesions in the central nervous system disseminated in both space (lesions in at least two areas of the brain or spinal cord) and time (new lesions on follow up MRI or simultaneous active and inactive lesions). This establishes MS as a disease with more than one lesion and more than one attack. The 2010 revisions improved sensitivity to 77% while maintaining high specificity at 92% for an overall accuracy of 86% in MS diagnosis.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    177 views5 pages

    McDonald Criteria Multiple Sclerosis

    Uploaded by

    Resa Budi Deskianditya
    The McDonald criteria are the diagnostic standards used to diagnose multiple sclerosis (MS). They were introduced in 2001 and revised in 2005 and 2010 to improve sensitivity while maintaining specificity. The criteria require evidence of lesions in the central nervous system disseminated in both space (lesions in at least two areas of the brain or spinal cord) and time (new lesions on follow up MRI or simultaneous active and inactive lesions). This establishes MS as a disease with more than one lesion and more than one attack. The 2010 revisions improved sensitivity to 77% while maintaining high specificity at 92% for an overall accuracy of 86% in MS diagnosis.

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    McDonald criteria

    The McDonald criteria for diagnosing multiple sclerosis were published in 2001 by a
    team led by Prof Ian McDonald, and were revised in 2005 and 2010.

    In common with all MS diagnostic criteria, they seek to establish evidence of damage to
    the central nervous system that is disseminated in time (evidence of episode of damage in
    the central nervous system at different dates) and disseminated in space (evidence of
    damage to at least two different parts of the central nervous system).

    The McDonald criteria use MRI evidence extensively and can allow for a diagnosis of
    multiple sclerosis to be made on the basis of one relapse, given the right evidence from
    scans.

    The criteria specify that an relapse or attack must last for at least 24 hours, must be a
    neurological disturbance typical of multiple sclerosis, and that there must be at least 30
    days between the onset of the first attacks and any subsequent attack - whether seen
    clinically or just on MRI - to count as two separate MS events.

    Clinical presentation
    Additional data needed for MS
    (person presenting to
    diagnosis
    neurologist)
    Two or more relapses; objective
    clinical evidence of two or more
    lesions; objective clinical evidence
    None
    of one lesion together with
    reasonable historical evidence of a
    previous relapse
    Two or more attacks; objective Dissemination in space shown by:
    clinical evidence of one lesion One or more MRI detected lesions
    typical of MS
    or
    Clinical presentation
    Additional data needed for MS
    (person presenting to
    diagnosis
    neurologist)
    Await a further relapse that
    demonstrates activity in another
    part of the central nervous system
    Dissemination in time shown by:
    MRI evidence showing both an active
    (current) and non-active (previous)
    lesion
    One attack; objective clinical
    or
    evidence of two or more lesions
    MRI evidence of a new lesion since a
    previous scan
    or
    Await a further relapse
    Dissemination in space shown by:
    One or more MRI detected lesions
    typical of MS
    or
    Await a further relapse that
    demonstrates activity in another
    part of the central nervous system
    One attack; objective clinical
    evidence of one lesion (known as Dissemination in time shown by:
    'clinically isolated syndrome') MRI evidence showing both an active
    (current) and non-active (previous)
    lesion
    or
    MRI evidence of a new lesion since a
    previous scan
    or
    Await a further relapse
    Clinical presentation
    Additional data needed for MS
    (person presenting to
    diagnosis
    neurologist)
    Continued progression for one year
    (determined by looking at previous
    symptoms or by ongoing observation)
    plus any two of:
    Insidious neurological progression
    One or more MRI detected lesions in
    suggestive of multiple sclerosis
    the brain typical of MS
    (typical for primary progressive MS)
    Two or more MRI detected lesions in
    the spinal cord
    Positive tests on cerebrospinal
    fluid drawn off by lumbar puncture

    Reference

    Polman CH, et al.


    Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria.
    Annals of Neurology 2011;69(2):292-302.
    read online

    Polman CH, et al.


    Diagnostic criteria for multiple sclerosis: 2005 revisions to the 'McDonald Criteria'.
    Annals of Neurology 2005;58:840-846.
    McDonald diagnostic criteria for
    multiple sclerosis
    Dr Frank Gaillard ◉ et al.

    McDonald's criteria are MRI criteria used in the diagnosis of multiple sclerosis were
    introduced in 2001, revised in 2005 and again recently in 2010. This latest revision
    improves sensitivity from 46% to 77% with a slight tradeoff in specificity (slight
    deterioration from 94% to 92%), with an overall accuracy of 86% 2.

    Dissemination in space
    Dissemination in space requires ≥1 T2 bright lesions in two or more of the following
    locations 1:

     periventricular
     juxtacortical
     infratentorial
     spinal cord

    o if a patient has a brainstem / spinal cord syndrome, the symptomatic lesion(s) are
    excluded from the criteria, not contributing to the lesion count

    Dissemination in time

    Dissemination in time can be established in one of two ways:

     a new lesion when compared to a previous scan (irrespective of timing)

    o T2 bright lesion and/or gadolinium enhancing

     presence of asymptomatic enhancing lesion and a non-enhancing T2 bright lesion on any one
    scan

    References
     1. Polman CH, Reingold SC, Banwell B et-al. Diagnostic criteria for multiple sclerosis: 2010
    revisions to the McDonald criteria. Ann. Neurol. 2011;69 (2): 292-302. doi:10.1002/ana.22366 - Free
    text at pubmed - Pubmed citation
     2. Swanton JK, Fernando K, Dalton CM et-al. Modification of MRI criteria for multiple sclerosis
    in patients with clinically isolated syndromes. J. Neurol. Neurosurg. Psychiatr. 2006;77 (7): 830-3.
    doi:10.1136/jnnp.2005.073247 - Free text at pubmed - Pubmed citation

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