Panel Revises Diagnostic Criteria for Multiple Sclerosis

It may take some time for Connecticut patients to get a diagnosis of multiple sclerosis, and an erroneous diagnosis is not uncommon. One of the difficulties is that no single test can identify the disease. Instead, clinicians generally must rule out other causes of the presented symptoms and then use a number of processes including lab tests, medical history, a clinical examination, and an MRI of the brain.

On Dec. 21, 2017, the online journal “The Lancet” published updated diagnostic criteria based on the findings and recommendations of an international panel with 30 members. The McDonald Criteria for the Diagnosis of Multiple Sclerosis has been the same since 2010, and experts felt that due to new knowledge and research, it was time for a review.

Some elements have remained the same while others have been changed or altered. One of the critical parts of diagnosing MS is identifying lesions in the nervous system in time and space, but under the new criteria, the site and type of lesion that can be used has been expanded. In some cases, oligoclonal bands in the spinal fluid can be used in a diagnosis as well. The panel also issued several recommendations including that the type of MS and its progression should be evaluated both at the time of diagnosis and later.

A misdiagnosis can be devastating to a person’s health in some cases and may delay treatment or even prove fatal. In a legal case dealing with a misdiagnosis, it is necessary to prove that a patient did not receive a reasonable standard of care. This recognizes that some conditions, such as MS, may not be immediately diagnosed by most doctors. However, if someone with cancer symptoms that most physicians would recognize received a cancer misdiagnosis, this might be considered medical malpractice.