Mantero Vittorio, Abate Lucia, Balgera Roberto, La Mantia Loredana, Salmaggi Andrea
Neurological Unit, MS Centre, A. Manzoni Hospital-ASST Lecco, Lecco, Italy.
Neurological Unit, ASST Valtellina Alto Lario, Sondrio, Italy.
J Clin Neurol. 2018 Jul;14(3):387-392. doi: 10.3988/jcn.2018.14.3.387.
McDonald criteria for multiple sclerosis diagnosis have been revised over the years, diagnostic procedures have been simplified and earlier diagnosis facilitated. The new 2017 revision introduces other important changes, with a further simplification for the diagnosis. Oligoclonal bands reassume a more relevant role in the workup.
We describe 3 typical cases of patients admitted for clinically isolated syndrome and illustrate how the application of the new criteria can change the diagnostic approach with respect to the previous criteria.
In two of the three cases a diagnosis of multiple sclerosis is now possible.
The new 2017 Multiple Sclerosis criteria may have an important impact in clinical practice with an earlier treatment to avoid the risk of disease dissemination. Their application requires a careful assessment to avoid misdiagnosis and mistreatments.
多年来，用于多发性硬化症诊断的麦克唐纳标准不断修订，诊断程序得以简化，有助于更早进行诊断。2017年的新修订引入了其他重要变化，使诊断进一步简化。寡克隆带在检查中重新发挥更重要的作用。
我们描述了3例因临床孤立综合征入院的典型病例，并说明新标准的应用如何改变相对于先前标准的诊断方法。
在这3例病例中的2例中，现在有可能诊断为多发性硬化症。
2017年新的多发性硬化症标准可能对临床实践产生重要影响，可更早进行治疗以避免疾病传播的风险。其应用需要仔细评估，以避免误诊和误治。
