MS Phenotype Classification (McDonald / Phenotype)
Clinical classification of multiple sclerosis phenotype based on disease course (RRMS, SPMS, PPMS, CIS) using the 2013 Lublin consensus criteria.
Score interpretation
Single demyelinating event. 50–85% risk of converting to MS within 10 years.
→ MRI brain and spine. CSF oligoclonal bands. Commence DMT if high-risk MRI lesions (McDonald criteria met). Neurology follow-up.
Discrete relapses with remission between attacks. Most common form (~85% of diagnoses).
→ DMT selection based on disease activity and patient preference. MS specialist review. Relapse management with steroids.
Gradual accumulation of disability following RRMS phase.
→ Siponimod (active SPMS) or cladribine. Rehabilitation. Symptom management. EDSS monitoring 6-monthly.
Progressive disability from disease onset with no clear relapses.
→ Ocrelizumab (ofatumumab for active PPMS). Physiotherapy. Neurorehabilitation. Symptom management.
Interpretation bands for the MS Classification. Apply clinical judgement and local guidance.
References
- Lublin FD et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83(3):278-286.
- Thompson AJ et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173.
Related
Curated clinical cross-links plus same-class fallbacks.
- AIR Score for Appendicitis · Diagnostic
- Spontaneous Bacterial Peritonitis (SBP) Diagnosis · Diagnostic
- Modified Alvarado Score (MANTRELS) for Appendicitis · Diagnostic
- New Orleans Head CT Decision Rule · Diagnostic
- CHALICE Rule for Childhood Head Injury · Diagnostic
- STONE Score for Uncomplicated Ureteral Stones · Diagnostic
- Dimethyl Fumarate · Disease-Modifying Therapy — Relapsing-Remitting Multiple Sclerosis
- Ocrelizumab · Multiple Sclerosis — Disease-Modifying Therapy
- Fingolimod · Multiple Sclerosis — Disease-Modifying Therapy
- Alemtuzumab · Multiple Sclerosis — Disease-Modifying Therapy
- Cladribine · Multiple Sclerosis — Disease-Modifying Therapy
- Ofatumumab · Multiple Sclerosis — Disease-Modifying Therapy
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.