The 2024 revision of the McDonald criteria – interactive webpage

This interactive webpage presents the 2024 revisions of the McDonald criteria for the diagnosis of multiple sclerosis, as defined by Montalban et al., Lancet Neurol. 2025, with the aim of improving accuracy and consistency in the application of the 2024 McDonald criteria.

Each column represents a possible combination of clinical presentations and paraclinical findings. These scenarios can be selected and combined to assess whether the 2024 McDonald criteria are fulfilled.

Detailed explanations for each item are available by clicking on the (i) button. Individual items can be selected, whereby the box color changing to green indicates inclusion.

The platform was developed by Ilaria Callegari, Athina Papadopoulou, Jakob Kel and Marcus D’Souza at Neurostatus-UHB with scientific guidance from Xavier Montalban, Alan Thomson, Timothy Coetzee, Maria Pia Sormani, Cristina Granziera and Ludwig Kappos.

1 attack with symptoms and signs characteristic of multiple sclerosis
Better explanation excluded
Lesions in ≥ 2 anatomical locations
and either of the following
CSF positivity
CVS positivity
DIT
Lesions in ≥ 4 anatomical locations
1 attack with symptoms and signs characteristic of multiple sclerosis
Better explanation excluded
Lesions in 1 anatomical location
and either of the following pairs
CSF positivity
AND
CVS positivity
CSF positivity
AND
PRL
DIT
AND
PRL
DIT
AND
CVS positivity
≥ 12 months progression
Better explanation excluded
and either of the following
Lesions in ≥ 2 anatomical locations
≥ 2 spinal cord lesions
and either of the following
CSF positivity
CVS positivity
DIT
Lesions in ≥ 4 anatomical locations
≥ 12 months progression
Better explanation excluded
Lesions in 1 anatomical location
and either of the following pairs
CSF positivity
AND
CVS positivity
CSF positivity
AND
PRL
DIT
AND
PRL
DIT
AND
CVS positivity
Incidental imaging finding or other non-specific presentation
Better explanation excluded
Lesions in ≥ 2 anatomical locations
and either of the following
CSF positivity
CVS positivity
DIT