Learning objectives
1.
To exhibit the new 2010 revised McDonald criteria emphasizing changes over time as well as their impact on the diagnostic management of patients with multiple sclerosis (MS).
2.
To establish the differential diagnosis with Devic's optic neuromyelitis (NMO) and with acute disseminated encephalitis (ADEM) and to illustrate them.
Background
The 2005 McDonald criteria,
based on the Barkhof-Tintoré criteria for establishing dissemination in space of lesions in the central nervous system,
were the best-known criteria in the diagnosis of patients with MS.
However,
they have been recently revised and modified so that new 2010 McDonald criteria are currently used.
The analysis of diagnostic criteria evolution on MRI evidence:
a) An effort to simplify the demonstration of the dissemination in space.
b) A clear intention to reduce the number of MRI required establishing existence of disseminations...
Conclusion
MRI is a highly sensitive and relatively specific technique for the identification of CNS demyelinating lesions
The MAGNIMS group has validated the 2010 McDonald criteria to simplify the early diagnosis of CDMS and PPMS,
with preservation of accuracy and specificity
They have been validated in patients with a typical CIS or suspected PPMS.
The NMO in Asian and Latin American adult populations and ADEM in children must be excluded
References
Chris H.
Polman PhD,
Stephen C.
Reingold Phd,
Brenda Banwell MD et al.
Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to the McDonald Criteria.
ANN NEUROL 2011;69:292–302
D.
J.
Rigotti PhD,
O.
Gonen PhD.
Is “Benign Multiple Sclerosis” really benign?.
REVISTA ESPAÑOLA DE ESCLEROSIS MÚLTIPLE Nº 14 - Junio de 2010
Polman CH,
Reingold SC,
Edan G,
et al.
Diagnostic criteria for multiple sclerosis: 2005 revisions to the ‘‘McDonald Criteria.’’ Ann Neurol 2005;58:840–846
Ketelslegers IA,
Neuteboom RF,
Boon M,
et al.
A comparison of MRI...