2010 McDonald criteria for diagnosing pediatric multiple sclerosis

被引：103

作者：

Sadaka, Yair ^{[2
]}

Verhey, Leonard H.

Shroff, Manohar M. ^{[3
]}

Branson, Helen M. ^{[3
]}

Arnold, Douglas L. ^{[4
]}

Narayanan, Sridar ^{[4
]}

Sled, John G. ^{[5
]}

Bar-Or, Amit ^{[6
,7
]}

Sadovnick, A. Dessa ^{[8
,9
]}

McGowan, Melissa

Marrie, Ruth Ann ^{[10
]}

Banwell, Brenda ^{[1
,2
]}

机构：

[1] Univ Toronto, Hosp Sick Children, Paediat Demyelinating Dis Program, Res Inst, Toronto, ON M5G 1X8, Canada

[2] Univ Toronto, Hosp Sick Children, Div Neurol, Toronto, ON M5G 1X8, Canada

[3] Univ Toronto, Hosp Sick Children, Div Neuroradiol, Dept Paediat, Toronto, ON M5G 1X8, Canada

[4] McGill Univ, Montreal Neurol Inst, McConnell Brain Imaging Ctr, Montreal, PQ, Canada

[5] Univ Toronto, Dept Med Biophys, Toronto, ON, Canada

[6] McGill Univ, Montreal Neurol Inst, Neuroimmunol Unit, Montreal, PQ, Canada

[7] McGill Univ, Montreal Neurol Inst, Expt Therapeut Program, Montreal, PQ, Canada

[8] Univ British Columbia, Fac Med, Dept Med Genet, Vancouver, BC, Canada

[9] Univ British Columbia, Fac Med, Div Neurol, Vancouver, BC, Canada

[10] Univ Manitoba, Dept Internal Med, Winnipeg Hlth Sci Ctr, Winnipeg, MB, Canada

来源：

ANNALS OF NEUROLOGY | 2012年 / 72卷 / 02期

基金：

加拿大健康研究院;

关键词：

MRI CRITERIA; PREDICT CONVERSION; PROGNOSTIC-FACTORS; GUIDELINES; PANEL; MS;

D O I：

10.1002/ana.23575

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: 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. Methods: 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. Results: 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 nonacute 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. Interpretation: Both 2005 and 2010 McDonald criteria identify children with relapsingremitting 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;72:211223.

引用

页码：211 / 223

页数：13