








The Schumacher criteria are a set of diagnostic
criteria that were developed in 1965 and are still commonly used by neurologists
to make a clinical diagnosis of multiple sclerosis. The Schumacher criteria
were updated in 1983 by the Poser Criteria.
The Schumacher criteria are:
-
Neurological examination reveals objective abnormalities
of central nervous system (CNS)
function.
-
History indicates involvement of two or more parts of CNS.
-
CNS disease predominately reflects white
matter involvement.
-
Involvement of CNS follows one of two patterns:
-
Two or more episodes, each lasting at least 24 hours and
at least one month apart.
-
Slow or stepwise progression of signs and symptoms over at
least 6 months.
-
Patient aged 10 to 50 years old at onset.
-
Signs and symptoms cannot be better explained by other disease
process.
Because there is no definitive laboratory (or other) test
for multiple sclerosis, the diagnosis is essentially a clinical one backed
up by other findings (eg. MRI scans,
spinal
taps, VEP tests, SSEP
tests etc.).
The Schumacher criteria led to the development of the
following designations, which, though still broadly applied, have been
updated with the advent of analysis of
cerebrospinal
fluid (CSF) by electrophoresis and
the ability to detect clinically silent lesions through MRI scans.
-
Clinically Definite MS.
Which was made if all the Schumacher criteria are fulfilled.
-
Probable MS.
Which refers to Relapsing/Remitting
MS (RRMS) symptoms where only one neurological symptom commonly associated
with MS is found or if there is only a single attack and there was no better
explanation for the symptoms.
-
Possible MS.
Which refers to RRMS symptoms without documented signs
or where the objective signs are insufficient to establish more than one
site of CNS involvement.
The Poser criteria have redefined these designations.
Schumacher Criteria Refs:
Schumacher GA, Beebe G, Kebler RF et al (1965)
Problems of experimental trials of therapy in multiple sclerosis. Ann.
NY Acad, Sci
Whitaker JN, Mitchell GW (1997) Clinical Features of multiple
sclerosis. Multiple Sclerosis: Clinical and pathogenic basis ISBN 0
412 30890 8
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