The 2010 McDonald criteria for the diagnosis of multiple sclerosis are widely used in research and clinical practice. Scientific advances in the past 7 years suggest that they might no longer provide the most up-to-date guidance for clinicians and researchers. The International Panel on Diagnosis of Multiple Sclerosis reviewed the 2010 McDonald criteria and recommended revisions. The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. The following changes were made: in patients with a typical clinically isolated syndrome and clinical or MRI demonstration of dissemination in space, the presence of CSF-specific oligoclonal bands allows a diagnosis of multiple sclerosis; symptomatic lesions can be used to demonstrate dissemination in space or time in patients with supratentorial, infratentorial, or spinal cord syndrome; and cortical lesions can be used to demonstrate dissemination in space. Research to further refine the criteria should focus on optic nerve involvement, validation in diverse populations, and incorporation of advanced imaging, neurophysiological, and body fluid markers.

中文翻译：

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多发性硬化症的诊断：麦当劳标准的2017年修订版。

2010年麦当劳诊断多发性硬化症的标准被广泛用于研究和临床实践。过去7年的科学进展表明，它们可能不再为临床医生和研究人员提供最新指南。国际多发性硬化症诊断小组审查了2010年麦当劳标准并建议进行修订。2017年的McDonald标准继续主要适用于经历典型临床孤立综合征的患者，定义了在CNS中实现病灶在时间和空间上的传播所需的条件，并强调没有必要为这种表现提供更好的解释。进行了以下更改：对于具有典型的临床孤立综合征并在空间传播的临床或MRI表现的患者，脑脊液特异性寡克隆带的存在可以诊断出多发性硬化症。有症状的病变可用于证实幕上，下颌或脊髓综合症患者的时空分布。皮质病变可用于证明在空间中的扩散。进一步完善标准的研究应集中在视神经受累，在不同人群中进行验证以及结合先进的影像学，神经生理学和体液标志物。