[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-525936-105":59,"doc-detail-525936-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","diagnosis-of-multiple-sclerosis-2024-mcdonald-criteria","Diagnosis of Multiple Sclerosis - 2024 McDonald criteria","","Objective: This article explains the features and clinical use of the 2024 McDonald criteria for diagnosing multiple sclerosis (MS). The updated criteria aim for broader applicability across ages and presentations, adding new diagnosis pathways supported by fluid and MRI biomarkers such as the kappa free light chain index, central vein sign, and paramagnetic rim lesions. It also expands dissemination in space to include optic nerve lesions assessed by MRI, optical coherence tomography, or visual evoked potentials. The criteria emphasize objective CNS involvement on imaging, allow pragmatic clinical-based diagnosis when paraclinical tools are unavailable, and highlight misdiagnosis risk with careful neurologic evaluation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/diagnosis-of-multiple-sclerosis-2024-mcdonald-criteria/525936/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/diagnosis-of-multiple-sclerosis-2024-mcdonald-criteria/525936.png","ImageObject",300,407,{"name":92,"@type":93},"Liam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-08",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the purpose of the 2024 McDonald criteria in MS diagnosis?","Question",{"text":113,"@type":114},"The 2024 McDonald criteria describe how MS can be identified or judged as highly likely in patients with typical presentations after other diagnoses are reasonably excluded.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What new biomarkers and MRI elements are incorporated in the updated criteria?",{"text":118,"@type":114},"The update includes fluid and MRI biomarkers such as the kappa free light chain index, central vein sign, and paramagnetic rim lesions.",{"name":120,"@type":111,"acceptedAnswer":121},"How do the criteria evaluate dissemination in space regarding the optic nerve?",{"text":122,"@type":114},"They add the optic nerve as a fifth anatomic location, requiring evidence of an optic nerve lesion demonstrated by MRI, optical coherence tomography, or visual evoked potentials.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},525936,1791607194,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":26,"preview_page_count":4},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Downloaded from [https://continuum.aan.com by Hebrew University of Jerusalem-Israel on 20 June 2026](https://continuum.aan.com by Hebrew University of Jerusalem-Israel on 20 June 2026)  \nDiagnosis of  \nMultiple Sclerosis  \nBy Georgina Arrambide, MD, PhD; Christine Lebrun-Fr´enay, MD, PhD, FAAN  \nABSTRACT  \nOBJECTIVE: This article describes the features and application of the 2024 McDonald criteria for the diagnosis of multiple sclerosis (MS) .  \nLATEST DEVELOPMENTS: The updated 2024 McDonald criteria are designed to be inclusive, with multiple new pathways to diagnosis that are applicable across the age spectrum and for patients with typical, nonspecific, or incidental presentations. New fluid and MRI biomarkers have been incorporated, including the kappa free light chain index, the central vein sign, and paramagnetic rim lesions. Anatomic regions for the fulfillment of dissemination in space now include the optic nerve as a fifth location, incorporating evidence of an optic nerve lesion demonstrated by either MRI, optical coherence tomography, or visual evoked potentials.  \nESSENTIAL POINTS: The 2024 McDonald criteria strongly recommend the confirmation of objective evidence of central nervous system involvement by imaging in addition to clinical findings, while additional biomarkers may be needed in specific instances. However, if these paraclinical tools are unavailable, a pragmatic approach incorporating clinical findings is permitted. MS diagnosis requires careful neurologic evaluation and expertise for the interpretation of paraclinical findings; the accurate performance of the diagnostic criteria still relies on the clinician’s knowledge of typical clinical presentations and MRI findings of MS and the recognition of red flags suggesting alternative diagnoses. The revised criteria can be applied at all ages and for asymptomatic individuals; however, caution is required to avoid misdiagnosis, particularly for pediatric, older-onset, and asymptomatic presentations.  \nINTRODUCTION  \nM  \nultiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS) characterized by inflammation, demyelination, and neurodegeneration.1 Its etiology remains elusive, and a combination of genetic, environmental, and epigenetic factors has been associated  \nwith MS.2 The lack of one or several apparent etiopathogenic factors and a heterogeneous clinical presentation and course require a comprehensive approach to diagnosis that integrates clinical, imaging, and CSF assessments. The diagnostic criteria for MS have evolved from the purely clinical Charcot  \nREVIEW ARTICLE  \nCONTINUUM AUDIO INT ERVIEW AVAI LABLEON LINE  \nCONTINUUM ALOUD RECORDING AVAI LABLEON LINE  \nC ITE AS :  \nCONTINUUM (MIN NEA P M INN) 2026;32(2, MULTIPLE SCLEROSIS AND RELATED DISORDERS):381 –404.  \nAddress correspondence to Dr Georgina Arrambide, Cemcat Building, Valld´Hebron University Hospital, Passeig Vall d´Hebron 119-129, 08035 Barcelona, Spain, [garrambide@cem-cat.org](garrambide@cem-cat.org); Dr Christine Lebrun-Fr´enay, Hˆopital Pasteur, 2 Voie Romaine, 06100 Nice, France, lebrun-frenay. c@chu-nice.fr.  \nRELATIONSHIP DISCLOSURE: Dr Arrambide has received personal compensation in the range of $0 to $499 for serving on a scientific advisory or data safety monitoring board for Platform Adaptive Trial for remyelination and neuroprotection in mUltiple Sclerosis (PLATYPUS) and in the range of $500 to $4999 for Continued on page 404  \nUNLABELED USE OF PRODUCTS/ INVESTIGATIONAL USE DISCLOSURE:  \nDrs Arrambide and LebrunFr´enay report no disclosure.  \nAll cases in this article are hypothetical or composite.  \n© 2026 American Academy of Neurology.  \nCONTINUUM . AAN . COM 381  \nCopyright © 2026 American Academy of Neurology. Unauthorized reproduction of this article is prohibited.  \nDownloaded from [https://continuum.aan.com by Hebrew University of Jerusalem-Israel on 20 June 2026](https://continuum.aan.com by Hebrew University of Jerusalem-Israel on 20 June 202","cbCaifKtLegeILGf","https://ap.wps.com/l/cbCaifKtLegeILGf","pdf",1232445,24,"English","# ABSTRACT\n# OBJECTIVE\n# LATEST DEVELOPMENTS\n# ESSENTIAL POINTS\n# INTRODUCTION\n# TYPICAL CLINICAL, MRI, AND CSF FINDINGS IN MULTIPLE SCLEROSIS\n## Clinical Findings","[{\"question\":\"What is the purpose of the 2024 McDonald criteria in MS diagnosis?\",\"answer\":\"The 2024 McDonald criteria describe how MS can be identified or judged as highly likely in patients with typical presentations after other diagnoses are reasonably excluded.\"},{\"question\":\"What new biomarkers and MRI elements are incorporated in the updated criteria?\",\"answer\":\"The update includes fluid and MRI biomarkers such as the kappa free light chain index, central vein sign, and paramagnetic rim lesions.\"},{\"question\":\"How do the criteria evaluate dissemination in space regarding the optic nerve?\",\"answer\":\"They add the optic nerve as a fifth anatomic location, requiring evidence of an optic nerve lesion demonstrated by MRI, optical coherence tomography, or visual evoked potentials.\"}]","Diagnosis of Multiple Sclerosis - 2024 McDonald criteria | PDF",1791493989]