The 2017 McDonald Criteria for Diagnosis of Multiple Sclerosis (MS)

The 2017 McDonald criteria continue to apply primarily to patients experiencing a typical clinically isolated syndrome, define what is needed to fulfil dissemination in time and space of lesions in the CNS, and stress the need for no better explanation for the presentation. Continue reading

Revised Criteria for the Clinical Diagnosis of Dementia with Lewy Bodies (DLB)

The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these.
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Revised IMWG Diagnostic Criteria for Multiple Myeloma

The International Myeloma Working Group (IMWG) consensus updates the disease definition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). Continue reading

MDS Clinical Diagnostic Criteria for Parkinson’s Disease (PD)

The prerequisite to apply the Movement Disorder Society (MDS-PD) criteria is the diagnosis of parkinsonism, which is based on three cardinal motor manifestations. Parkinsonism is defined as bradykinesia, in combination with either rest tremor, rigidity, or both. These features must be clearly demonstrable and not attributable to confounding factors. Continue reading

DSM-V Diagnostic Criteria for Insomnia

The American Academy of Sleep Medicine defines insomnia as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.

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Diagnostic Criteria for Delirium

Delirium is also known as acute confusional state, altered mental status, and toxic metabolic encephalopathy, among more than 30 descriptive terms. Delirium can be thought of as acute brain failure and is the final common pathway of multiple mechanisms, similar to acute heart failure. The official definition of delirium in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), requires a disturbance in attention and awareness that develops acutely and tends to fluctuate. The pathophysiological mechanisms of delirium remain poorly understood; leading models include neurotransmitter imbalance and neuroinflammation.

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Diagnosis of Porphyria

The porphyrias are disorders of heme synthesis, which has eight steps. Each type of porphyria involves a defect, either inherited or acquired, in a pathway enzyme. When the defect is physiologically significant, it results in overproduction of pathway precursors preceding the defective step which enter the circulation and are excreted into urine or bile. The diseases have been grouped as acute hepatic porphyrias and photocutaneous porphyrias. The acute porphyrias are due to hepatic overproduction of the porphyrin precursors, delta aminolevulinic acid and porphobilinogen, and the symptoms are caused by injury primarily to the nervous system. Cutaneous porphyria is due to overproduction of photosensitizing porphyrins by the liver or bone marrow, depending on the type of porphyria.

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