2017 McDonald diagnostic criteria: A review of the evidence

The diagnosis of Multiple Sclerosis (MS) has continuously evolved, allowing for an earlier and more accurate diagnosis of MS over time. The McDonald Criteria for diagnosis of MS were originally proposed in 2001, with previous revisions in both 2005 and 2010. The International Panel on Diagnosis in MS have recently reviewed the 2010 McDonald Criteria, and made recommendations for the revised 2017 McDonald Criteria. Any revisions made relied entirely on the available evidence, and not expert opinion. In this review, we provide an overview of the recent 2017 revisions to the McDonald Criteria, focusing in particular on the motivating evidence behind the recommendations made. We also review the existing research around misdiagnosis in MS, as well as areas considered to be high priorities of research, currently lacking in sufficient evidence, which may influence future diagnostic criteria in years to come. Finally, we illustrate some clinical examples, to demonstrate the impact of new diagnostic criteria on time to MS diagnosis in a real-world setting.