{"id":10756,"date":"2026-10-29T20:37:48","date_gmt":"2026-10-29T20:37:48","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=10756"},"modified":"2026-10-29T20:37:48","modified_gmt":"2026-10-29T20:37:48","slug":"mcdonald-criteria-for-diagnosis-of-multiple-sclerosis-ms","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/mcdonald-criteria-for-diagnosis-of-multiple-sclerosis-ms\/","title":{"rendered":"Criterios de McDonald para el diagn\u00f3stico de la esclerosis m\u00faltiple (EM)"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>La revisi\u00f3n m\u00e1s reciente corresponde a los criterios de McDonald de 2024, publicados en The Lancet Neurology en septiembre de 2025. Esta actualizaci\u00f3n modifica la versi\u00f3n de 2017 e incorpora nuevos biomarcadores de resonancia magn\u00e9tica y pruebas del l\u00edquido cefalorraqu\u00eddeo para facilitar un diagn\u00f3stico m\u00e1s temprano y preciso de la esclerosis m\u00faltiple (EM).<!--more--><\/p>\n<p>Los criterios se aplican a pacientes con sospecha de EM, incluidas las formas recurrentes y progresivas. El diagn\u00f3stico requiere una evaluaci\u00f3n cl\u00ednica y paracl\u00ednica adecuada, adem\u00e1s de excluir otras enfermedades que expliquen mejor los hallazgos.<\/p>\n<p><strong>Principales cambios de la revisi\u00f3n de 2024<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 226px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 25px;\">\n<td style=\"width: 27.5336%; height: 25px;\"><strong>Caracter\u00edstica<\/strong><\/td>\n<td style=\"width: 72.4664%; height: 25px;\"><strong>Criterios de McDonald 2024<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 27.5336%; height: 24px;\">Regiones anat\u00f3micas<\/td>\n<td style=\"width: 72.4664%; height: 24px;\">Cinco regiones del sistema nervioso central (SNC), con incorporaci\u00f3n del nervio \u00f3ptico<\/td>\n<\/tr>\n<tr style=\"height: 25px;\">\n<td style=\"width: 27.5336%; height: 25px;\">Diseminaci\u00f3n en el espacio (DIS)<\/td>\n<td style=\"width: 72.4664%; height: 25px;\">Lesiones en localizaciones caracter\u00edsticas del SNC<\/td>\n<\/tr>\n<tr style=\"height: 25px;\">\n<td style=\"width: 27.5336%; height: 25px;\">Diseminaci\u00f3n en el tiempo (DIT)<\/td>\n<td style=\"width: 72.4664%; height: 25px;\">Sigue siendo relevante, pero ya no es obligatoria en todas las v\u00edas diagn\u00f3sticas<\/td>\n<\/tr>\n<tr style=\"height: 51px;\">\n<td style=\"width: 27.5336%; height: 51px;\">Biomarcadores en LCR<\/td>\n<td style=\"width: 72.4664%; height: 51px;\">Bandas oligoclonales o \u00edndice de cadenas ligeras libres kappa elevado pueden aportar evidencia complementaria<\/td>\n<\/tr>\n<tr style=\"height: 25px;\">\n<td style=\"width: 27.5336%; height: 25px;\">Biomarcadores avanzados de RM<\/td>\n<td style=\"width: 72.4664%; height: 25px;\">Signo de la vena central (CVS) y lesiones con borde paramagn\u00e9tico (PRL)<\/td>\n<\/tr>\n<tr style=\"height: 51px;\">\n<td style=\"width: 27.5336%; height: 51px;\">Presentaciones cl\u00ednicas<\/td>\n<td style=\"width: 72.4664%; height: 51px;\">Se ampl\u00edan las v\u00edas diagn\u00f3sticas para incluir determinados casos asintom\u00e1ticos y s\u00edndromes radiol\u00f3gicamente aislados<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>Las cinco regiones anat\u00f3micas<\/p>\n<ol>\n<li>Periventricular: Lesiones en contacto directo con los ventr\u00edculos laterales.<\/li>\n<li>Cortical o yuxtacortical: Lesiones que afectan la corteza cerebral o la sustancia blanca inmediatamente adyacente.<\/li>\n<li>Infratentorial: Lesiones en el tronco encef\u00e1lico o el cerebelo.<\/li>\n<li>M\u00e9dula espinal: Lesiones intramedulares caracter\u00edsticas.<\/li>\n<li>Nervio \u00f3ptico: Evidencia de afectaci\u00f3n del nervio \u00f3ptico, evaluada mediante resonancia magn\u00e9tica apropiada, tomograf\u00eda de coherencia \u00f3ptica (OCT) o potenciales evocados visuales (PEV).<\/li>\n<\/ol>\n<p>La incorporaci\u00f3n del nervio \u00f3ptico constituye uno de los principales cambios anat\u00f3micos de la revisi\u00f3n de 2024.<\/p>\n<p>\u00bfC\u00f3mo se establece el diagn\u00f3stico?<br \/>\nLa v\u00eda diagn\u00f3stica integra la presentaci\u00f3n cl\u00ednica, la distribuci\u00f3n de las lesiones en la resonancia magn\u00e9tica y los biomarcadores complementarios.<\/p>\n<ul>\n<li>Diseminaci\u00f3n en el espacio (DIS): presencia de lesiones caracter\u00edsticas en varias regiones del SNC, seg\u00fan la v\u00eda diagn\u00f3stica aplicable.<\/li>\n<li>Diseminaci\u00f3n en el tiempo (DIT): evidencia de actividad de la enfermedad en distintos momentos, como lesiones nuevas en la RM o lesiones que captan y no captan gadolinio simult\u00e1neamente.<\/li>\n<li>Biomarcadores complementarios: bandas oligoclonales restringidas al LCR, \u00edndice de cadenas ligeras libres kappa elevado en el LCR, signo de la vena central o lesiones con borde paramagn\u00e9tico, cuando se cumplen las condiciones espec\u00edficas de aplicaci\u00f3n.<\/li>\n<\/ul>\n<p>Es importante destacar que los criterios de 2024 permiten diagnosticar a determinados pacientes sin demostrar diseminaci\u00f3n en el tiempo. En algunas v\u00edas, la presencia de lesiones caracter\u00edsticas en cuatro de las cinco regiones del SNC puede permitir establecer el diagn\u00f3stico sin DIT, siempre que se cumplan los dem\u00e1s requisitos. Otras v\u00edas requieren evidencia cl\u00ednica o paracl\u00ednica adicional.<\/p>\n<p>Diagn\u00f3sticos diferenciales y precauciones<br \/>\nAntes de diagnosticar EM, deben considerarse otras enfermedades que pueden presentar manifestaciones similares, entre ellas:<\/p>\n<ul>\n<li>Trastorno del espectro de la neuromielitis \u00f3ptica (anticuerpos AQP4-IgG).<\/li>\n<li>Enfermedad asociada a anticuerpos contra la glicoprote\u00edna de la mielina de los oligodendrocitos (MOGAD).<\/li>\n<li>Enfermedad isqu\u00e9mica de peque\u00f1os vasos y lesiones de sustancia blanca asociadas a migra\u00f1a.<\/li>\n<li>Otras enfermedades inflamatorias, infecciosas, metab\u00f3licas o gen\u00e9ticas.<\/li>\n<\/ul>\n<p>Los criterios deben ser aplicados por profesionales con experiencia en enfermedades desmielinizantes, especialmente ante presentaciones at\u00edpicas, en ni\u00f1os y en adultos mayores de 50 a\u00f1os.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Montalban X, et al. Diagnosis of multiple sclerosis: 2024 revisions of the McDonald criteria. The Lancet Neurology. 2025;24(10):850\u2013865. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40975101\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Zettl UK, Rommer PS, Wattjes MP, Tumani H, Hecker M. Concerns regarding the 2024 revisions of the McDonald criteria for diagnosis of multiple sclerosis. Lancet Neurol. 2026 Jun;25(6):542. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/42127923\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Oct 29, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>La revisi\u00f3n m\u00e1s reciente corresponde a los criterios de McDonald de 2024, publicados en The Lancet Neurology en septiembre de 2025. Esta actualizaci\u00f3n modifica la versi\u00f3n de 2017 e incorpora nuevos biomarcadores de resonancia magn\u00e9tica y pruebas del l\u00edquido cefalorraqu\u00eddeo para facilitar un diagn\u00f3stico m\u00e1s temprano y preciso de la esclerosis m\u00faltiple (EM).<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"footnotes":""},"categories":[2],"tags":[16,123,471,469,93],"class_list":["post-10756","post","type-post","status-publish","format-standard","hentry","category-neurology","tag-criteria","tag-diagnosis","tag-mcdonald","tag-multiple","tag-sclerosis"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Criterios de McDonald para el diagn\u00f3stico de la esclerosis m\u00faltiple (EM) - MedicalCRITERIA.com<\/title>\n<meta name=\"description\" content=\"McDonald criteria for multiple sclerosis diagnosis: MRI findings, CSF biomarkers, and diagnostic updates.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicalcriteria.com\/web\/mcdonald-criteria-for-diagnosis-of-multiple-sclerosis-ms\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"[:es]Criterios de McDonald para el diagn\u00f3stico de la esclerosis m\u00faltiple (EM)[:en]McDonald Criteria for Diagnosis of Multiple Sclerosis (MS)[:] - 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