Clinical Application of 2017 McDonald Diagnostic Criteria for Multiple Sclerosis

J Clin Neurol. 2018 Jul;14(3):387-392. doi: 10.3988/jcn.2018.14.3.387.

Abstract

Background and purpose: McDonald criteria for multiple sclerosis diagnosis have been revised over the years, diagnostic procedures have been simplified and earlier diagnosis facilitated. The new 2017 revision introduces other important changes, with a further simplification for the diagnosis. Oligoclonal bands reassume a more relevant role in the workup.

Methods: We describe 3 typical cases of patients admitted for clinically isolated syndrome and illustrate how the application of the new criteria can change the diagnostic approach with respect to the previous criteria.

Results: In two of the three cases a diagnosis of multiple sclerosis is now possible.

Conclusions: The new 2017 Multiple Sclerosis criteria may have an important impact in clinical practice with an earlier treatment to avoid the risk of disease dissemination. Their application requires a careful assessment to avoid misdiagnosis and mistreatments.

Keywords: McDonald criteria; clinically isolated syndrome; criteria; multiple sclerosis; oligoclonal bands.