2017 Revised McDonald Criteria for Multiple Sclerosis
Seon-Ah Lee1, Jee-Eun Kim, MD, PhD2
1Research Institute, Seoul Medical Center, Seoul, Korea 2Department of Neurology, Seoul Medical Center, Seoul, Korea
Diagnostic criteria for multiple sclerosis continue to evolve with clinical, laboratory and technical
advancements. Although the 2010 McDonald criteria are well applicable in clinical and research settings,
recent efforts were made by the International Panel on Diagnosis of Multiple Sclerosis to simplify
and improve diagnosis of the disease in the early phase without reducing specificity. In the 2017
McDonald criteria, three important modifications were made. First, a positive oligoclonal band in cerebrospinal
fluid can be substituted for dissemination in time in patients presenting with the typical
clinically isolated syndrome and go well with dissemination in space criteria. Second, symptomatic
MRI lesions can also be considered for dissemination in space or time. Third, cortical lesions on MRI
can be regarded as juxtacortical lesions for dissemination in space. Validation of the 2017 McDonald
criteria in a diverse population is needed, and incorporation of evidence of optic nerve involvement
or other biomarkers into multiple sclerosis criteria will require further investigation.
Journal of Multiple Sclerosis 9(2):15-20, 2018
