McDonald Criteria MS

McDonald criteria for MS diagnosis.

Neurologists use a checklist called the McDonald criteria to confirm a diagnosis of MS.1,2 For an accurate diagnosis, there needs to be evidence of MS-related damage to the central nervous system that shows dissemination across both time and space (occurring at different times or dates and in different areas):1–3

To assess this, your doctor will consider any ‘attacks’ of MS-like symptoms that you have experienced and will evaluate your MRI scans for signs of any activity that indicates MS and how these have changed over time.1,2 They may also consider the results of your lumbar puncture test, which checks your spinal fluid for MS disease activity that has occurred in the past.2

style
bg-none,pt-6,pb-6
style
bg-none,pt-6,pb-6

The McDonald criteria were first published in 2001 and later revised in 2017, to allow earlier diagnosis.3 The revised 2017 guidelines are summarised in the table below:3,4

What signs of MS are already seen?
Is anything else needed to confirm a diagnosis of MS?
Two or more relapses or objective clinical evidence of 1 lesion

Evidence of nerve damage (referred to as lesions) affecting at least 2 different areas:

  • Additional lesions assessed using MRI
  • Another relapse resulting in damage to a different part of the CNS
One relapse and objective clinical evidence of 2 or more lesions

Evidence of nerve damage occurring at different points in time:

  • Evidence of proteins in the cerebrospinal fluid known as oligoclonal bands
  • A new lesion since previous scan using MRI
  • Another relapse
One relapse and objective clinical evidence of 1 lesion

Evidence of nerve damage (referred to as lesions) affecting at least 2 different areas:

  • Additional lesions assessed using MRI
  • Another relapse resulting in damage to a different part of the CNS

Evidence of nerve damage occurring at different points in time:

  • Evidence of proteins in the cerebrospinal fluid known as oligoclonal bands
  • A new lesion since previous scan using MRI
  • Another relapse
Slow and continual neurological progression suggestive of MS

Continued progression  (or worsening of symptoms) for 1 year irrespective of relapses, plus any two of the following:

  • Additional lesions in the brain typical of MS assessed using MRI
  • Two or more lesions in the spinal cord assessed using MRI
  • Evidence of proteins in the cerebrospinal fluid known as oligoclonal bands
Two or more relapses AND EITHER objective clinical evidence of 2 or more lesions in the central nervous system (CNS) OR objective clinical evidence of 1 lesion with reasonable evidence to suggest there has already been a relapse in the past
No
heading
Just in case you’re interested, the McDonald criteria guidelines in more detail

There are a lot of tests that come with an MS diagnosis. These articles could help.

Each article relates to a different test or method used to help diagnose MS. All explained as openly and clearly as possible.
/content/the-ms-resistance/ro/ro/about-ms/diagnosis/blood-test
/content/the-ms-resistance/ro/ro/about-ms/diagnosis/evoked-potential
/content/the-ms-resistance/ro/ro/about-ms/diagnosis/lumbar-test
/content/the-ms-resistance/ro/ro/about-ms/diagnosis/mri
/content/the-ms-resistance/ro/ro/about-ms/diagnosis/neurological-exam
style
bg-aqua,pt-5,pb-5
  1. Garg N, Smith TW. Brain Behav. 2015;5:e00362.
  2. Polman CH, et al. Ann Neurol. 2011; 69:292–302.
  3. Thompson AJ, et al. Lancet Neurol. 2018;17:162–73.
  4. MS Trust. McDonald criteria. https://www.mstrust.org.uk/a-z/mcdonald-criteria [accessed May 2020].
heading
References
referenceMode
true