Clinical aspects of multiple sclerosis in childhood

Abstract

Introduction: Multiple sclerosis (MS) is an autoimmune, demyelinating, and inflammatory disease affecting the central nervous system. This condition has an unknown etiology and variable prevalence, being more common in young adult females. The prevalence of MS in childhood is low, ranging from 2% to 4% of all cases. Objectives: This study aims to describe the clinical development and symptoms of MS in children, contrasting them with the development of MS in adults. Dessign: This is an integrative literature review. Methods: Ten articles were selected from the PubMed and SciELO in English and Portuguese between 2010 and 2020. The keywords used were Multiple Sclerosis and Pediatric. Results: The prevalence of MS in children presenting with clinical symptoms is estimated to be between 2% and 5% of all MS cases. Despite variations in prevalence, the relapsing-remitting subtype and female predominance are similar to MS in adults. The female-to-male ratio ranges from 1.13:1 to 3.88:1. The relapsing-remitting subtype accounted for 85.7% to 100% of cases. While there is no typical presentation of clinical symptoms, optic neuritis, motor alterations, sensory changes, and cerebellum and brain stem dysfunctions are frequently reported. Unlike what is observed in adults, MS in children typically presents in a more diverse range of ways and progresses more rapidly and severely, with multifocal presentations. Also, children experience slower illness progression due to higher neuroplasticity but reach the impairment milestone before adults. Conclusion: The clinical presentation of multiple sclerosis in childhood is diverse, presenting different characteristics of adults. There is no consensus on the most prevalent symptoms. However, there are similarities in gender and subtype between children and adults with the disease.