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The McDonald criteria are diagnostic criteria for multiple sclerosis (MS). 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 McDonald criteria for the diagnosis of multiple sclerosis were revised in 2005 to clarify exactly what is meant by an "attack", "dissemination" and a "positive MRI", etc.〔 For some people McDonald's criteria are a clinical definition, being therefore 100% sensitive respect themselves. For others, they are just some diagnosis criteria and therefore have to be evaluated against other more basic criteria, like biopsies or autopsies. Sensitivity and specificity of McDonald's criteria is low in the initial phases of MS, currently around 46% and 63% respect the criterium "conversion to definite in 40 months".〔J K Swanton et al. Modification of MRI criteria for multiple sclerosis in patients with clinically isolated syndromes, ''J Neurol Neurosurg Psychiatry.'' Jul 2006; 77(7): 830–833. 〕 Sensitivity of these criteria in general can be around 25% lower than pathological MS because of silent MS cases The "CIS to MS conversion" criteria is widely accepted to evaluate diagnosis criteria in early phases. Currently, the best predictor of future development of clinical multiple sclerosis is the number of T2 lesions visualized by magnetic resonance imaging after the CIS.〔Cramer SP1, Modvig S2, Simonsen HJ3, Frederiksen JL4, Larsson HB5. Permeability of the blood-brain barrier predicts conversion from optic neuritis to multiple sclerosis. Brain. 2015 Jul 17. pii: awv203. PMID 26187333〕 There is an ongoing discusion about whether MS should be considered a pathological or clinical entity. The original article of McDonald states that "MS is a clinical entity and therefore should be 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".〔 The 2010 McDonald criteria are regarded as the gold standard for MS diagnosis. ==Diagnostic Criteria== 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「McDonald criteria」の詳細全文を読む スポンサード リンク
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