MS experts are recommending updates to the 2017 McDonald diagnostic criteria that aim to make diagnosis easier, faster and more accurate.
Among its recommendations, the expert panel advises incorporating optic nerve imaging for diagnosis and applying stricter criteria for older patients. In addition, it proposes that radiologically isolated syndrome may be diagnosed as MS in certain cases and that disease dissemination in time should no longer be required.
The committee broached the topic of RIS, which is identified by the incidental discovery of central nervous system white matter T2-weighted hyperintense foci on MRI. These hyperintense foci demonstrate morphological and spatial characteristics highly typical of MS but without clinical symptomatology related to inflammatory demyelination.
Evidence also suggests that kappa free light chains could serve as a valid, simpler, and rater-independent alternative to detecting OCBs, he added. Because KFLCs are interchangeable with OCBs, they can be used in place of OCBs for diagnosing MS through CSF analysis.The panel is also calling for stricter criteria for confirming an MS diagnosis in those over age 50 or individuals withor vascular disorders.
These examples help illustrate how using the new criteria, for example optic nerve imaging, could lead to earlier diagnoses, and, in some cases, easier diagnoses, possibly with less CSF, he said. It could also lead to fewer misdiagnoses, he added, thanks to high-specificity tools.
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