Help-Line 01233 334879

 

Proventus

Making Life Fairer

 

Working Together to Make a Difference

UK Charity No 1131517

Working together to make a difference

We are a member of the Fund Raising Standards Board

 

We are all volunteers and the advice we receive is also given freely.

 

All donations are used to further the work we do.

Please Donate

 

Join Us

 

Provide Support

Buy At

 

UK Charity

No 1131517

 

Copyright © Proventus 2010

 

Terms & Conditions

 

Multiple Sclerosis

It is important to remember that MS is only one part of a person and not the person.

MS does not represent them, it is not their identity, they are as normal as the next person.  

Find Us Here

McDonald Criteria                                                                                                                                                                                    

Published in 2001 and revised in 2005.

In common with all MS diagnostic criteria it seeks to establish evidence of damage to the central nervous system that is:

• Disseminated in time - evidence of lesions forming in the central nervous system at different dates.
• Disseminated in space - evidence of damage to at least two different parts of the central nervous system.

 

The McDonald criteria use MRI evidence extensively to confirm an MS diagnosis, together with lumbar puncture evidence in some instances. They allow for an MS diagnosis to be made on the basis of one relapse, given the correct MRI evidence.

 

The criteria specify that                                                                                                                                                                             

• An attack or relapse must last for at least 24 hours.
• It must be a neurological disturbance typical of MS.
• 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.
• Currently, people with MS may be diagnosed using these criteria.

 

Presenting to neurologist                                                                                                                                                                         

Choice of additional data needed for MS diagnosis is either :

 

1                                                                                                                                                                                                                    

• Two or more attacks - objective clinical evidence of two or more lesions.
• Two or more attacks - objective clinical evidence of one lesion plus dissemination in space shown on MRI.

Or

• Up to two MRI detected lesions typical of MS plus positive cerebrospinal fluid.

Or

• Wait for a further relapse suggestive of dissemination in space - ie affecting another part of the body.

Or

• One attack - objective clinical evidence of two or more lesions plus dissemination in time demonstrated by MRI.

Or

• Second clinical attack - relapse.

 

2

• One attack - objective clinical evidence of one lesion - known as clinically isolated syndrome plus dissemination in space demonstrated by MRI.

Or

• Up to two MRI detected lesions typical of MS plus positive cerebrospinal fluid as well as dissemination in time demonstrated by MRI.

Or

• Dissemination in time demonstrated by MRI - ie new lesion seen on MRI at least 3 months after the original scan.

Or

• Second clinical attack - relapse.

 

3

• Insidious neurological progression suggestive of multiple sclerosis - typical for primary - progressive MS plus positive cerebrospinal fluid as well as dissemination in space, shown on MRI.

Or

• Abnormal visual evoked potential plus abnormal MRI as well as dissemination in time demonstrated by MRI.

Or

• Continued progression for one year.

[1] [2]

 

 

Differential Diagnosis                                                                                                                                                                                

The individual symptoms of MS are not unique to the condition and could be caused by one of a range of possible explanations.

 

Differential diagnosis is the process by which a neurologist narrows down the list of the possible diagnoses from which the correct diagnosis will be extracted during and after further investigation.

 

 

1. Adapted from: Compson A, et al. McAlpine's Multiple Sclerosis. 4th ed. 2005.

2. Polman CH, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the 'McDonald Criteria'. Annals of Neurology 2005;58:840-846.

 

Top of Page