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Updated Criteria to Accelerate Multiple Sclerosis Diagnosis

January 11, 2018

A 30-member international panel of multiple sclerosis (MS) experts recently revised the McDonald Criteria for the Diagnosis of Multiple Sclerosis, according to a press release from the National Multiple Sclerosis Society.

The lack of a single diagnostic test for MS presents a challenge to both patients and health care providers alike. Patients can experience adverse events for an undetermined amount of time while their providers work to determine the cause of the symptoms.

The current diagnostic process includes evaluating information from clinical examination, medical history, laboratory tests, and MRI imaging of the brain and spinal cord. These tests are intended to rule out other neurological conditions.

“Treating MS early and effectively is our best current way to limit permanent damage to the nervous system, so speeding the diagnosis of MS with improved accuracy is an important goal,” said Bruce Cohen, MD, professor, Davee Department of Neurology and Clinical Neurosciences, Northwestern University, and chair of the National MS Society’s National Medical Advisory Committee.

A key to diagnosing MS is the occurrence of lesions in the brain and spinal cord that demonstrates whether there is damage in more than 1 place in the nervous system (dissemination in space) and that the damage has happened repeatedly (dissemination in time), according to the release.

Due to a substantial amount of data that has emerged since the 2010 version was released, a panel revised the McDonald Criteria to improve the speed and accuracy of MS diagnosis. The latest edition of the criteria was published in The Lancet Neurology.  

There were several components of the criteria that have not changed in the updated guidelines:
·      MS should be diagnosed by a provider with related expertise, in addition to confirmatory imaging and testing.
·      Dissemination of lesions in space and time are still required, but providers can now do so through additional avenues.
·      Confirming there is no alternative diagnosis is a crucial consideration.
·      The criteria still apply to patients with a typical clinically isolated syndrome (CIS).

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