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Multiple Sklerose – Revision der neuen McDonald-Diagnosekriterien

Revision of McDonald’s new diagnostic criteria for multiple sclerosis

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Zusammenfassung

Im Jahr 2001 wurden durch ein internationales Gremium neue diagnostische Kriterien für die Multiple Sklerose (MS) vorgeschlagen, die sich durch die Integration klinischer, bildgebender (MRT) und paraklinischer Befunde für die Erleichterung der Diagnosestellung auszeichnen. Diese so genannten „McDonald-Kriterien“ haben seither große Akzeptanz und Verbreitung gefunden. Zwischenzeitlich haben sich eine Reihe von Publikationen mit der Sensitivität und Spezifität für die Diagnosestellung sowie der Umsetzung dieser neuen MS-Kriterien in der klinischen Praxis befasst. Basierend auf diesen Erfahrungswerten unter Einbeziehung neuerer Daten zur MS hat eine internationale Expertengruppe kürzlich eine Revision der Kriterien verfasst. Wesentliche Änderungen betreffen (1.) die MRT-Kriterien für die Disseminierung von Läsionen über die Zeit, (2.) die Rolle von Rückenmarksläsionen in der MRT und (3.) die Diagnosestellung einer primär progredienten MS. Die Erfahrungen der letzten Jahre mit den McDonald-Kriterien sowie die revidierten Kriterien werden hier dargestellt.

Summary

In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.

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Danksagung

Wir danken Frau Anke Bauer, Sekretariat Klinische Forschungsgruppe MS und Neuroimmunologie Würzburg, für die Hilfe bei der Erstellung und Editierung des Manuskriptes.

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Authors and Affiliations

  1. Neurologische Klinik und Poliklinik, Julius-Maximilians-Universität, Würzburg

    H. Wiendl

  2. Neurologische Klinik, Klinikum der Ruhr-Universität, Bochum

    R. Gold

  3. Institut für Klinische Neuroimmunologie, Ludwig-Maximilians-Universität, München

    R. Hohlfeld

  4. Abteilung für Neuroradiologie, Julius-Maximilians-Universität, Würzburg

    M. Bendszus

  5. Neurologische Klinik, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf

    B. C. Kieseier &  H.-P. Hartung

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  2. B. C. Kieseier
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Wiendl, H., Kieseier, B.C., Gold, R. et al. Multiple Sklerose – Revision der neuen McDonald-Diagnosekriterien . Nervenarzt 77, 1235–1245 (2006). https://doi.org/10.1007/s00115-006-2127-6

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