Recommended Diagnostic Criteria for Multiple Sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis

The International Panel on MS Diagnosis presents revised diagnostic criteria for multiple sclerosis (MS). The focus remains on the objective demonstration of dissemination of lesions in both time and space. Magnetic resonance imaging is inte-grated with clinical and other paraclinical diagnostic methods. The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including “monosymptomatic ” disease suggestive of MS, disease with a typical relapsing-remitting course, and disease with insidious progression, without clear attacks and remissions. Previously used terms such as “clinically definite ” and “probable MS ” are no longer recommended. The outcome of a diagnostic evaluation is either MS, “possible MS ” (for those at risk for MS, but for whom diagnostic evaluation is equivocal), or “not MS.” Ann Neurol 2001;50:121–127 Because no single clinical feature or diagnostic test is sufficient for the diagnosis of multiple sclerosis (MS), diagnostic criteria have included a combination of both clinical and paraclinical studies.1,2 The last for-mal review of criteria for MS diagnosis occurred in 1982,2 at which time degrees of diagnostic certainty were identified by categories ranging from clinicall