Clinical features of children and adolescents with multiple sclerosis

Abstract

There is increasing appreciation that multiple sclerosis (MS) can begin in childhood or adolescence, but pediatric MS continues to be a rare entity, with an estimated 2 to 5% of patients with MS experiencing their first clinical symptoms before age 16. A prompt diagnosis of pediatric MS is important to optimize overall management of both the physical and social impact of the disease. The widespread use of disease-modifying therapies (DMT) for MS in adults, as early as following an initial isolated episode, has led to the use of DMT in children and adolescents with MS. However, it is imperative to distinguish pediatric MS from other childhood CNS inflammatory demyelinating disorders such as acute disseminated encephalomyelitis. Although increasing evidence suggests a slower disease course in children with MS compared to adults, significant disability can still accumulate by early adulthood. Furthermore, associated neurocognitive deficits can impair both academic and psychosocial function at a critical juncture in a young person's life. This article reviews the clinical characteristics, neuroimaging, paraclinical findings, disease course, epidemiology, genetics, and pathophysiology of pediatric MS vis-à-vis adult MS. Further research of pediatric MS may advance our understanding of MS pathophysiology in general, as well as improve the long-term health care outcomes of children and adolescents diagnosed with MS.

Cyclophosphamide therapy in pediatric multiple sclerosis

“…16 Acute relapse-related care for pediatric MS typically involves IV corticosteroids. 17 IV immunoglobulin (IVIg) and plasma exchange are employed in refractory cases.…”

Pediatric multiple sclerosis in Venezuela

“…Recently, there is emerging evidence which proves that MS can manifest in childhood and adolescence. In addition, the challenges in its differential diagnosis make the diagnosis in this age group a difficult task 7 . Other disorders, including leukodystrophies and metabolic diseases, may masquerade the clinical picture of MS in pediatric patients.…”

Pediatric multiple sclerosis: analysis of clinical and epidemiological aspects according to National MS Society Consensus 2007

“…Looking for evidence based on medicine on childhood MS, it was possible to detect lack of studies and, in addition, analysis limited to small samples. Only four studies were published between 1958 and 2005 with more than a hundred cases, all of them at geographic regions of high MS prevalence 4 .…”