Diagnostic criteria for multiple sclerosis: a comparison of the Poser and the McDonald criteria / 中华神经科杂志

ABSTRACT

Objective To compare the Poser and the McDonald diagnostic criteria for multiple sclerosis (MS).Methods Sixty-seven patients with clinical features suggestive of MS were re-evaluated by 2 neurologists utilizing both the Poser and the McDonald criteria.The Fisher' s exact test was used to statistically analyze the data from assessment by these two criteria.Results By the Poser criteria, 34 patients were classified as clinically definite MS, 24 patients as laboratory supported definite MS and 9 patients as possible MS.Under the new McDonald criteria, MS was diagnosed in 36 patients and 31 patients had possible MS.The results revealed significant differences in diagnosing MS between these 2 criteria (OR=5.549, 95% CI 2.37-13.00, P<0.01).Conclusions These 2 criteria showed remarkable differences in diagnosing MS, in particular definite MS, possibly due to greater reliance on paraclinical evidences in the Poser criteria and more stringent gnidlines of magnetic resonance imaging (MRI) in the McDonald criteria.The analysis of cerebrospinal fluid may increase the diagnostic rate of MS and specify pathologic abnormalities in MRI to some degree.