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  • "Poser Criteria for MS"

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    Old 04-13-2006, 11:51 AM   #1
    Lisa_P
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    "Poser Criteria for MS"

    I just read a bit about what is definite MS, what is probable MS, and what is possible MS. I think it's really telling. In a matter of days, I went through all the diagnoses and never knew how they decided. Now, three years later, I think I see it.

    First it was "possible MS" when I presented with my second documented optic neuritis. After my MRI and a neuro-psych evaluation, it was suddenly "Probable" and that dx stuck after my LP came back "consistent with MS." I think; however, that were I to get a copy of my records I would see that the final diagnosis was "Laboratory supported Definite MS."

    [I really don't know why that makes me frown because I felt such a sense of liberation when I was able to "connect the dots" and understand my 'weird' medical history.]
    The Poser criteria are:

    Clinically definite MS
    2 attacks and clinical evidence of 2 separate lesions
    2 attacks, clinical evidence of one and paraclinical evidence of another separate lesion

    Laboratory supported Definite MS
    2 attacks, either clinical or paraclinical evidence of 1 lesion, and cerebrospinal fluid (CSF) immunologic abnormalities
    1 attack, clinical evidence of 2 separate lesions & CSF abnormalities
    1 attack, clinical evidence of 1 and paraclinical evidence of another separate lesion, and CSF abnormalities

    Clinically probable MS
    2 attacks and clinical evidence of 1 lesion
    1 attack and clinical evidence of 2 separate lesions
    1 attack, clinical evidence of 1 lesion, and paraclinical evidence of another separate lesion

    Laboratory supported probable MS
    2 attacks and CSF abnormalities

     
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    Old 04-13-2006, 01:31 PM   #2
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    Re: "Poser Criteria for MS"

    Lisa, thanks for posting this. I had read it early on but couldn't remember where. This is the "new" criteria, right? I'm quite sure it was this criteria that got me a relatively speedy dx. I too would fall into the "Laboratory Supported Definite MS" catagory.

     
    Old 04-13-2006, 02:22 PM   #3
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    Question Re: "Poser Criteria for MS"

    Hi, what does the term "paraclinical" mean?

    Thanks!
    1Thes518
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    Old 04-13-2006, 05:04 PM   #4
    Lisa_P
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    Re: "Poser Criteria for MS"

    It was put together in 1983. I'm not sure if it's been rewritten at all, though...

    Paraclinical... Well, the comining form "para-" is somewthing closely related, something "almost..." So, practically speaking, I think it's a "medi-speak"
    way of saying something looks like a duck, sounds like a duck, etc...

     
    Old 04-13-2006, 08:29 PM   #5
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    Re: "Poser Criteria for MS"

    Lisa P,

    In 2001 the International board of neurologist adopted a new criteria called the Mcdonald Criteria.
    Since MRI's have been used now for a clinical diagnosis they have revised the criteria.The majority of the large MS clinics are using it now.

    Toni

     
    Old 04-14-2006, 05:36 AM   #6
    Lisa_P
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    Re: "Poser Criteria for MS"

    Great! I'll Google that and see what I see.

    ....And I see that it was revised LAST year:

    The revised criteria for diagnosis of MS include the following:

    ~At least two attacks with objective clinical evidence of at least two lesions;
    ~At least two attacks with objective clinical evidence of one lesion plus dissemination in space shown on MRI or two or more MRI lesions consistent with MS plus positive CSF finding or second clinical attack;
    ~One attack with objective clinical evidence of at least two lesions plus dissemination in time on MRI or second clinical attack;
    ~One attack with objective clinical evidence of one lesion, plus dissemination in space shown on MRI or two or more MRI lesions consistent with MS plus positive CSF finding and dissemination in time shown on MRI or second clinical attack;
    ~Insidious neurologic progression suggestive of MS plus one year of disease progression determined retrospectively or prospectively and two of the following: positive brain MRI result (nine T2 lesions or at least four T2 lesions with positive Visual Evoked Potential), positive spinal cord MRI result with two focal T2 lesions, and positive CSF findings.


    SO.... Since I've never seen the MRI or LP reports, I dunno WHAT's going on! I DO have a copy of the cognitive functioing results and they aren't very encouraging. Oh well.

    I do know that the MS I had in 2003 (at diagnosis) was no where near as troubling to me as it is NOW in terms of my ability to function well on a daily basis (i.e., my 15+ years as an admin. asst. were blown out the window at that time and in 2004, I had to leave my PART TIME job as a receptionist/health club attendant because my hours were reduced to nearly nothing after I took too long to recover from a car accident! So I just dropped out of the job market. Now I just take care of my home and mooch off my common-law husband.)

    Ain't life GRAND!?!!

    Last edited by Lisa_P; 04-14-2006 at 06:02 AM.

     
    Old 04-14-2006, 12:13 PM   #7
    orngcrayon
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    Re: "Poser Criteria for MS"

    This is so confusing! I've only had one attack.... but I've had two neurologist independently say "You DEFINATELY have MS." One of them even went into it saying there's no way I had it... so I really believed her.

    I have only one lesion on my brain - I don't know about my spinal MRI or how the LP came back (I thought both were normal, but I was VERY out of it during my diagnosis). The word "probable" or "possible" was never said to me, just "It's MS", twice.


     
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