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Revised McDonald Criteria for Multiple Sclerosis Diagnosis

>=2 attacks
Per Polman, et. al, 2010: “An attack is defined as a neurologic disturbance of the kind seen in MS. It can be documented by subjective report or by objective observation, but it must last for at least 24 hours. Pseudoattacks and single paroxysmal episodes must be excluded. To be considered separate attacks, at least 30 days must elapse between onset of one event and onset of another event.”
No
Yes
Objective clinical MRI evidence of >=2 lesions
Per Polman, et. al, 2010: “Clinical diagnosis based on objective clinical findings for 2 attacks is most secure. Reasonable historical evidence for 1 past attack, in the absence of documented objective neurological findings, can include historical events with symptoms and evolution characteristics for prior inflammatory demyelinating even; at least 1 attack however must be supported by objective findings.”
No
Yes
Objective clinical evidence of 1 lesion with reasonable historical evidence of a prior attack
No
Yes
Periventricular
No
Yes
Juxtacordial
No
Yes
Infratentorial
No
Yes
Spinal Cord
No
Yes
A new T2 and/or gadolinium-enhancing lesion(s) on follow-up MRI, with reference to a baseline scan, irrespective of the timing of baseline scan.
No
Yes
Simultaneous presence of asymptomatic gadolinium-enhancing and nonenhancing lesions at any time.
No
Yes
One year of disease progression (retrospective or prospective)
No
Yes
Evidence of dissemination in space in the spinal cord
Based on ≥2 T2 lesions in the spinal cord
No
Yes
Positive CSF
Isoelectric focusing evidence of oligoclonal bands and/or elevated IgG index
No
Yes
Result:

Background

Result Interpretation

Ranges Ranges