No specific test or set of criteria now exists for making a definitive diagnosis of MS. The current, generally accepted diagnostic standard, known as the revised McDonald criteria, was first described in 2005 and is based on the patient's history, diagnostic tests, results of neurologic examination, and findings on MRI. A positive diagnosis requires at least two distinct, CNS-related neurologic symptoms occurring in different anatomical locations and on different occasions, which are not caused by another disease process. An MRI scan performed at least 30 days after the onset of symptoms and showing lesions compatible with MS can be used to establish a second episode of the disease in the absence of prior clinical evidence of its presence. Further tests for the diagnosis of MS may include analysis of the CSF to detect an elevated immunoglobulin (Ig)G index, and=or the finding on protein electrophoresis of bands indicating oligoclonal IgG in the CSF but not in the serum. An electroencephalogram may show a greater than normal number of evoked potentials. Additional testing may be needed to exclude other causes, such as chronic infectious disease, of clinical symptoms often seen in MS.
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