Nieuwe diagnostische criteria voor multiple sclerose in de praktijk

In two women, aged 29 and 49 years respectively, and a man aged 44 years, neurological signs pointed to multiple sclerosis (MS). In 2001, an international panel of experts revised the diagnostic criteria for multiple sclerosis (MS), which had been in use since 1983. As before, the fundamental diagnostic criterion remains dissemination in time and place of neurological abnormalities suggestive of demyelination. In contrast to the old criteria, the new criteria give diagnostic rules for the diagnosis of primary progressive MS. An even more important step is the further integration of MRI results in the new diagnostic criteria. This allows neurologists to diagnose MS earlier in the disease course, as was the case in the first woman: three months after the first symptoms a new MRI scan revealed dissemination in time. Recent research has shown, that MRI scans are reliable and can be used in clinical practice. If used correctly, the reliability of the diagnosis will also improve. The male patient had word-finding problems that do not fit with MS, and there were more than 9 MRI abnormalities, including juxtacortical, but no periventricular and infratentorial abnormalities. He had a vasculopathy. The second woman had dissemination in time and place, but there was a better explanation for the symptoms: neuromyelitis optica.