Members of the Canadian Pediatric Demyelinating Disease Network are described in the Appendix on pages 11-12.
2010 McDonald criteria for diagnosing pediatric multiple sclerosis†
Article first published online: 27 AUG 2012
Copyright © 2012 American Neurological Association
Annals of Neurology
Volume 72, Issue 2, pages 211–223, August 2012
How to Cite
Sadaka, Y., Verhey, L. H., Shroff, M. M., Branson, H. M., Arnold, D. L., Narayanan, S., Sled, J. G., Bar-Or, A., Sadovnick, A. D., McGowan, M., Marrie, R. A., Banwell, B. and on behalf of the Canadian Pediatric Demyelinating Disease Network (2012), 2010 McDonald criteria for diagnosing pediatric multiple sclerosis. Ann Neurol., 72: 211–223. doi: 10.1002/ana.23575
- Issue published online: 27 AUG 2012
- Article first published online: 27 AUG 2012
- Accepted manuscript online: 4 MAR 2012 10:08PM EST
- Manuscript Accepted: 24 FEB 2012
- Manuscript Revised: 28 JAN 2012
- Manuscript Received: 22 SEP 2011
The diagnosis of multiple sclerosis (MS) rests on confirmation of central nervous system inflammatory disease that is disseminated in space and time, as evidenced clinically or by magnetic resonance imaging (MRI). The 2010 McDonald criteria simplified MRI requirements, and newly proposed that the criteria are also suitable for the diagnosis of pediatric MS.
In a national prospective incident cohort study of children with acute demyelination observed for a minimum of 24 months, baseline and serial clinical and MRI examinations were used to retrospectively evaluate the 2010 and 2005 McDonald criteria using clinically relapsing disease as the gold standard.
Of 212 eligible participants, 34 experienced 2 or more clinical attacks, 58 met the 2010 criteria, and 42 met 2005 McDonald criteria. The 2010 criteria demonstrated high sensitivity (100%), specificity (86%), positive predictive value (76%), and negative predictive value (100%) for children older than 11 years with non–acute disseminated encephalomyelitis (ADEM) presentations, as did the 2005 McDonald criteria. In younger children with a non-ADEM presentation, PPV of the 2010 criteria was only 55%. None of the 50 children with ADEM met clinical criteria for MS, but 10 met 2010 and 4 met 2005 criteria.
Both 2005 and 2010 McDonald criteria identify children with relapsing–remitting MS, although caution is suggested when applying these criteria in younger children. The 2010 McDonald criteria are simple and enable an early diagnosis of MS, but are not suited for application in the context of ADEM-like presentations. ANN NEUROL 2012;72:211–223.