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Diagnosis of PPMS

Hi, is it possible for someone to be diagnosed, on the basis of their MS symptoms, with Primary Progressive MS but without a lumbar puncture? I was under the impression that the lumbar puncture was required. Thanks in advance for any replies.

The Revised McDonald Criteria includes diagnosis of Primary Progressive Multiple Sclerosis (PPMS). Positive if: ≥1 year of disease progression (this can be determined either prospectively or retrospectively) Plus two of the following three criteria: 1 Brain dissemination in space 2 Spinal cord dissemination in space 3 Positive CSF (oligoclonal bands and/or elevated IgG index) If there are lesions in the brain and spinal cord as well as at least a year of disease progression then PPMS can be diagnosed.

I wonder how many people who are dx’d with ppms have in fact experienced episode/incidents which with the benefit of hindsight could be regarded as linked to m.s. That is they have had relapsing-remitting form of m.s. If that is right then these people would be dx’d as spms.

[quote=“albrecht durer”] The Revised McDonald Criteria includes diagnosis of Primary Progressive Multiple Sclerosis (PPMS). Positive if: ≥1 year of disease progression (this can be determined either prospectively or retrospectively) Plus two of the following three criteria: 1 Brain dissemination in space 2 Spinal cord dissemination in space 3 Positive CSF (oligoclonal bands and/or elevated IgG index) If there are lesions in the brain and spinal cord as well as at least a year of disease progression then PPMS can be diagnosed. [/quote] Who ‘controls’ or revises the McDonald Criteria? Is there a H Q of neuros which decides these and other things and then pass on instructions to other neuros?