2005 Revised McDonald Diagnostic Criteria for MS

What Is An Attack?

• Neurological disturbance of kind seen in MS

• Subjective report or objective observation

• 24 hours duration, minimum

• Excludes pseudo-attacks, single paroxysmal episodes

Determining Time Between Attacks

• 30 days between onset of event 1 and onset of event 2

What is a Positive MRI?2,3

3 out of 4 of the following:

• 1 Gd-enhancing brain or cord lesion or 9 T2 hyperintense brain and/or cord

lesions if there is no Gd-enhancing lesion

• 1 or more brain infratentorial or cord lesion

• 1 or more juxtacortical lesion

• 3 or more periventricular lesions

Note: Individual cord lesions can contribute along with individual brain lesions to reach required

number of T2 lesions

What Provides MRI Evidence of Dissemination in Time?

• A Gd-enhancing lesion detected in a scan done at least 3 months after onset of initial

clinical event at a site different from the initial event

or

• A new T2 lesion detected in a scan done at any time compared to a reference scan done

at least 30 days after initial clinical event

What is Positive CSF?

Oligoclonal IgG bands in CSF (and not serum) or elevated IgG index

What is Positive VEP?

Delayed but well-preserved wave form

National Multiple Sclerosis Society

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http://www.NationalMSSociety.org/PRC