McDonald criteria
MS diagnostic criteria used in neurology for the diagnosis of multiple sclerosis. Main principle of an MS diagnosis is to demonstrate the spatial and temporal spread ( dissemination) of inflammatory entmarkenden herds (also called plaques) in the central nervous system.
Historically, there are four important detailed elaborations of the diagnostic criteria, the change reflects the input of new investigation techniques into the MS diagnosis. The Schumacher criteria of 1965 and the Rose criteria from 1976 were based primarily on medical history and clinical neurological findings raised. The Poser criteria from 1983 based an additional findings that can be gained by examination of the cerebrospinal fluid ( CSF). The McDonald criteria published in 2001 emphasized the importance of imaging findings of the MRI scan. 2005, these criteria were revised again. They have since been referred to as "revised McDonald criteria ."
Diagnostic criteria according to Rose 1976
According to these rules, criteria for a unique, a probable and possible clinical diagnosis have been established. The unique clinical diagnosis relies on the detection of a typical course of disseminated lesions in younger adult patients. The probable diagnosis must be made with a documented frequently occurring symptom in detecting relapses. A possible diagnosis may be made when a disease flare is documented, the symptoms can not be clearly assigned to a central lesion but.
Diagnostic criteria according to Poser 1983
A recent diagnostic algorithm provided for in addition that one can provide a safe clinical diagnosis, when they perform laboratory findings (MRI, CSF and EP) can be supported. Consequently, we must provide a safe clinical diagnosis, if there are two disjointed central lesions in either the time course or as part of a current investigation. Found clinically only one lesion, a reliable diagnosis can be made if one can prove a second lesion by laboratory tests ( EP or MRI): for ex paraspastis the legs and pathological VEPs ( visual evoked potentials ). Here, the CSF should always be pathological.
McDonald criteria of 2001 and its revision of 2005 and 2010
2001 proposed an international panel of experts present new criteria for the diagnosis of MS, which emphasizes the importance of imaging in addition to clinical findings ( MRI) ( McDonald criteria ). Also paraclinical findings ( CSF analysis and evoked potentials) were taken into account; However, they lost against imaging findings in importance. Based on studies that dealt with the sensitivity and specificity of the McDonald criteria, 2005 and 2010 were revised. This revised McDonald criteria are characterized overall by a facilitated diagnosis of MS. It is important to note that a diagnosis of MS can not be made if the charges pathological findings can be better explained by another disorder.
The following summary table shows the exact version of the revised McDonald criteria:
If the criteria are met and no better explanation for the clinical presentation is, the diagnosis of MS. If it is suspected, the criteria are not fully met, the diagnosis is possible MS. If another diagnosis, the results of the clinical presentation better explained during the diagnostic process, the diagnosis is no MS.
2010 experienced the McDonald criteria, a further revision:
1 or more T2 lesions in at least two of the MS- typical regions ( periventricular, juxtakortikal, infratentorial, spinal ) OR Waiting on new impetus with new Läsionslokalisation
Simultaneous detection of asymptomatic gadolinium - receiving and non- receiving lesions, OR detection of a new T2 or gadolinium - absorbing lesion in the control MRI independent of time, OR Waiting on new thrust
1 1 or more T2 lesions in MS- typical regions periventricular, juxtakortikal, infratentorial 2 2 or more 3 spinal lesions detection of intrathecal IgG synthesis