McDonald criteria

Multiple sclerosis

McDonald criteria are diagnostic criteria used in the diagnosis of multiple sclerosis (MS). These criteria are named after Ian McDonald, a British neurologist who played a significant role in their development.

History

The McDonald criteria were first published in 2001, with revisions made in 2005, 2010, and 2017. The aim of these criteria is to enable the diagnosis of MS in patients with a single clinical attack and positive magnetic resonance imaging (MRI) findings.

Criteria

The McDonald criteria incorporate clinical, radiological, and laboratory findings. The 2017 revision of the McDonald criteria includes the following:

• Evidence for at least two attacks of neurological dysfunction, with objective clinical evidence for at least one.
• Evidence for at least one attack of neurological dysfunction, with objective clinical evidence for at least two lesions.
• Evidence for dissemination in space (DIS) and time (DIT) on MRI, or a positive cerebrospinal fluid (CSF) analysis.
• No better explanation for the clinical presentation.

Use

The McDonald criteria are widely used in clinical practice and research settings for the diagnosis of MS. They have been shown to be highly sensitive and specific for the diagnosis of MS.

Criticism

Despite their widespread use, the McDonald criteria have been criticized for their complexity and for the potential for over-diagnosis of MS.

See also

• Multiple sclerosis
• Neurology
• Magnetic resonance imaging
• Cerebrospinal fluid

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