These criteria are named after neurologist W. Ian McDonald.
In April 2001, an international panel in association with the National Multiple Sclerosis Society (NMSS) of America recommended revised diagnostic criteria for MS. They discourage the previously used terms such as "clinically definite" and "probable MS", and propose as diagnostic either "MS", "possible MS", or "not MS".
They have undergone revisions in 2005 and 2010. They make use of advances in magnetic resonance imaging (MRI) techniques and are intended to replace the Poser criteria and the older Schumacher criteria. The new criteria facilitate the diagnosis of MS in patients who present with signs and symptoms suggestive of the disease. These include monosymptomatic disease, disease with a typical relapsing-remitting course or insidious progression but no clear attacks and remissions. The original article of McDonald states that "MS is a clinical entity and therefore should be diagnosized [sic] with clinical and paraclinical criteria".Nevertheless, they acknowledge the existence of lesion-based MS definition, saying that some other groups consider that "the only proved diagnosis of MS can be made upon autopsy, or occasionally upon biopsy, where lesions typical of MS can be directly detected through standard histopathological techniques".
| Clinical Presentation | Additional Data Needed |
|---|---|
| * 2 or more attacks (relapses) * 2 or more objective clinical lesions | None; clinical evidence will suffice (additional evidence desirable but must be consistent with MS) |
| * 2 or more attacks * 1 objective clinical lesion | Dissemination in space, demonstrated by: * MRI * or a positive CSF and 2 or more MRI lesions consistent with MS * or further clinical attack involving different site |
| * 1 attack * 2 or more objective clinical lesions | Dissemination in time, demonstrated by: * MRI * or second clinical attack |
| * 1 attack * 1 objective clinical lesion (monosymptomatic presentation) | Dissemination in space demonstrated by: * MRI * or positive CSF and 2 or more MRI lesions consistent with MS and Dissemination in time demonstrated by: * MRI * or second clinical attack |
| Insidious neurological progression suggestive of MS (primary progressive MS) | One year of disease progression (retrospectively or prospectively determined) and
Two of the following:
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