Schumacher criteria

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