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New diagnostic criteria and phenotypes of MS

      Diagnostic criteria for multiple sclerosis (MS) have evolved over time, with the McDonald criteria appearing in 2001, incorporating for the first time imaging abnormalities to provide evidence for both dissemination in time and space. The increasing incorporation of paraclinical assessment (especially imaging) to supplement clinical findings has allowed for earlier, more sensitive and more specific diagnosis. This complements the increasing evidence base supporting the therapeutic benefits of early intervention. The most recent recommendations from the International Panel on Diagnosis of MS appeared in 2011. Availability of new data, emerging new technology, and evolving consensus warranted a further re-examination of the McDonald criteria and their utility. Meetings of an enlarged international panel took place in Philadelphia (November 2016) and Berlin (May 2017). The panel emphasized the importance of expert clinical assessment in minimizing mis-diagnosis and focused on a number of key issues including further clarification of the utilization of imaging findings and the contribution of CSF oligoclonal bands to the diagnostic criteria. It also identified some key areas of further research towards further evolution of the diagnostic criteria.
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