McDonald Diagnostic Criteria for Multiple Sclerosis

Този инструмент е преднаначен само за образователни цели и не представлява професионален съвет или заместител на професионален съвет. Инструментът не трябва да се използва за предоставяне на медицинска диагноза и/или лечение.

Общо описание
Инструментът определя дали пациентът отговаря на критериите на Макдоналд, 2017 г. за множествена склероза с пристъп в началото на заболяването и пациенти с ход на заболяването, който се характеризира с прогресиране от началото на заболяването (първично прогресивна форма на множествена склероза).

A monophasic clinical episode with patient-reported symptoms and objective findings reflecting a focal or multifocal inflammatory demyelinating event in the CNS, developing acutely or subacutely, with a duration of at least 24 h, with or without recovery, and in the absence of fever or infection; similar to a typical multiple sclerosis relapse (attack and exacerbation) but in a patient not known to have multiple sclerosis. A clinically isolated syndrome can be monofocal (reflecting pathology in a single location) or multifocal; the specific manifestations of a clinically isolated syndrome depend on the anatomical location (or locations) of the pathology. Typical presentations include unilateral optic neuritis, focal supratentorial syndrome, focal brainstem or cerebellar syndrome, or partial myelopathy; examples of atypical presentations include bilateral optic neuritis, complete ophthalmoplegia, complete myelopathy, encephalopathy, headache, alteration of consciousness, meningismus, or isolated fatigue.

Patient is classified as having MS if:

• They have ≥ 2 attacks and ≥ 2 lesions
• They have ≥2 attacks and 1 lesion and historical evidence of a previous attack involving a lesion in a distinct anatomical location
• They have ≥ 2 attacks and 1 lesion and dissemination in space
• They have 1 attack and ≥ 2 lesions and dissemination in time
• They have 1 attack and 1 lesion and dissemination in time and dissemination in space

Patients are classified as having MS if primary criteria is fulfilled and two of the secondary criteria are fulfilled.

Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018; 17 (2): 162–73.

NICE guidelines. Multiple sclerosis in adults: management. Clinical guideline 186. Published: 8 October 2014.