How to Make Diagnosis of Multiple Sclerosis

        Diagnostic criteria commonly used is the McDonald’s criteria, which Multiple Sclerosis criteria with the original concept in 2001 and last revised in 2010. McDonald’s criteria emphasize the separation by time / disseminated in time  two or more attacks) and separation by space / disseminated in space (two or more different diagnoses topis). Someone diagnosed definitely with Multiple Sclerosis  when there is a separation of time and space that is clinically proven clinically or when evidence is incomplete but is supported by the investigation  MRI, CSF or VEP).

         Time separation point is the occurrence of two or more attacks in which the distance between the two attacks at least 30 days and at least one episode of attack lasted 24 hours. While separation by space is the presence of two or more objective neurological symptoms that reflect two different topisnya lesion diagnosis.

Definite criteria (disseminated in space ) MRI must include 3 of the 4 criteria :
( 1 ) the presence of one large lesions or at least 9 small lesions
( 2 ) at least one infratentorial lesion
( 3 ) at least 1 lesion juxtacortical
( 4 ) at least 3 periventricular lesions .

 In addition it can be seen on MRI cortical atrophy is preceded by ventricular enlargement .

       Examination of cerebrospinal fluid oligoclonal bands / LCS greatly aid in the diagnosis of MS. The sensitivity of this test is said to reach 95 % and if there is an increase in oligoclonal bands in the CSF only 2 lesions on MRI are needed to meet the criteria disseminated in space.

     Examination VEP (visual evoked potential) is quite sensitive investigations (other than the examination evoked potential) to MS where there is a lengthening of the VEP latency caused demyelinisasi the optic nerve. VEP can detect early abnormalities in MS patients although clinically there has been no clinical symptoms of neuritis optics.
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