McDonald diagnostic criteria for multiple sclerosis: 2010 (superseded)

A.Prof Frank Gaillard et al.

McDonald diagnostic criteria 2010 were MRI criteria used in the diagnosis of multiple sclerosis. They were introduced in 2001, revised in 2005, 2010 (the focus of this article) and in 2016 (by MAGNIMS) 1. The latest revision was in 2017 2.

Below are the previously used criteria, which should no longer be employed clinically. 

As before the diagnosis of multiple sclerosis requires establishing disease disseminated in both space and time. 

Dissemination in space requires T2 bright lesions in two or more of the following locations 1:

  • periventricular (≥ 3 lesions)
  • cortical or juxtacortical (≥1 lesion)
  • optic nerve (≥1 lesion)
  • infratentorial (≥1 lesion)
  • spinal cord (≥1 lesion)

Dissemination in time can be established in one of two ways:

  • a new lesion when compared to a previous scan (irrespective of timing)
    • T2 bright lesion and/or gadolinium-enhancing
  • presence of asymptomatic enhancing lesion and a non-enhancing T2 bright lesion on any one scan

In addition to the above criteria, the diagnosis of primary progressive multiple sclerosis has also been revised. The diagnosis now requires: 

  • ≥1 year of disease progression (this can be determined either prospectively or retrospectively)
  • fulflil the general criteria for dissemination in space
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    T2 bright brain or cord lesions: ≥1 in 2+ locations
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