1. Multiple Sclerosis Diagnostic Issues Christopher Bourque

7. McDonald Criteria Next slide 1 0 (progression from onset) Dissemination in space by MRI or positive CSF and 2 or more MRI lesions consistent with MS and dissemination in time by MRI or second clinical attack 1 1 monosymptomatic Dissemination in time by MRI or second clinical attack 2 or more 1 Dissemination in space by MRI or positive CSF and 2 or more MRI lesions consistent with MS or further clinical attack involving different site 1 2 or more None 2 or more 2 or more Additional Requirements to Make Diagnosis Objective Lesions Clinical (attacks)

8. McDonald Criteria Positive CSF and Dissemination in space by MRI evidence of 9 or more T2 brain lesions or 2 or more cord lesions or 4-8 brain and 1 cord lesion or positive VEP with 4-8 MRI lesions or positive VEP with less than 4 brain lesions plus 1 cord lesion and Dissemination in time by MRI or continued progression for 1 year 1 0 (progression from onset) Additional Requirements to Make Diagnosis Objective Lesions Clinical (attacks)

11. MS Symptoms Source: Whitaker JN, Mitchell GW 1997 100 88 87 82 63 39 49 42 41 23 10 4 Visual/oculomotor Paresis Paresthesias Incoordination Genitourinary/bowel Cerebral During course % Presenting % Deficit reported

23. MS Symptoms Source: Whitaker JN, Mitchell GW 1997 100 88 87 82 63 39 49 42 41 23 10 4 Visual/oculomotor Paresis Paresthesias Incoordination Genitourinary/bowel Cerebral During course % Presenting % Deficit reported